Evaluation of nonsurgical management of pneumoperitoneum in neonates

Abstract

ABSTRACT Background: Surgery has been the standard for managing the pneumoperitoneum (PP). There are sporadic reports of conservative management of PP in a certain group of patients. This study was conducted to analyze whether nonoperative management of PP is successful in neonates and infants or not. Methods: In this retrospective cohort study, neonates with PP were admitted and evaluated. They were managed by per abdomen needle decompression. Clinical parameters such as heart rate, respiratory rate, and temperature were recorded. An assessment of abdominal girth at the umbilical level was made, both before and after the peritoneal tapping. Tapping was done a maximum of two times at 24 h intervals. Results: Eighteen patients were managed conservatively. Eight patients responded to single tapping, four patients to two, and the remaining six patients needed laparotomy. In a follow-up of 3 months, these patients did not reveal any complications or complaints. Conclusion: Needle decompression appears to be effective as a surgical treatment in a select group of neonates with PP. This may be a viable treatment option in patients of PP avoiding surgery.