Management of neonatal spontaneous intestinal perforation by peritoneal needle aspiration

Objective:to describe conservative management of spontaneous intestinal perforation (sip) in preterm infants using peritoneal needle aspiration (pna).study design:monocentric retrospective review of sip cases treated primarily by pna between 1999 and 2015 (n=31).results:mean gestational age was 29.2±2.4 weeks and birthweight 1149±428 g. sip occurred at 3.7±2.2 days of life. pna achieved definitive treatment in 18 patients (60%) with a mean of 1.8 (±0.8) procedures. all patients requiring more than three pnas had secondary laparotomy. two patients died and five presented severe cerebral lesions. full enteral feeding was achieved 42±18 days after sip. intestinal morbidity included cholestasis (n=6), intestinal stricture (n=1) and growth restriction (n=22). on follow-up (n=25, median=4 years), no severe impairment was noted. seventeen children (68%) had a normal development.conclusion:pna as primary therapy for sip is a viable option, resulting in definitive treatment in 60% of cases, with limited mortality and morbidity.