Muhammad Sharif, Hashim I, Mahmood N, Nabeela Talaat, Muhammad Saleem.
Pattern, outcome and risk factors contributing to Pneumoperitoneum in Neonates.
Pak J Med Health Sci Jan ;14(2):426-9.

Background: Pneumoperitoneum in neonates is one of the major causes of mortality and morbidity. Neonatal pneumoperitoneum (NP) can be either surgical or non-surgical both. In case of Surgical NP, the most common cause is gastrointestinal perforation which is basically an emergency. Data about aetiology, pattern, and risk factors contributing to neonatal pneumoperitoneum and its final outcome is lacking in our setup. Aim: To look into the pattern of pneumoperitoneum in neonates, risk factors associated with its aetiology and final outcome so that its management and preventive aspects may be improved in neonates. Methods: An observational descriptive study was conducted in department of pediatric surgery children hospital and the institute of child health Lahore Pakistan from 1st July 2016 to 31st Dec 2017 to assess pattern, identify risk factors contributing to pneumoperitoneum and its final outcome in neonates. Results: A total of 191 neonates with pneumoperitoneum were included in this study.132(69%) were males. 97(50.7%) neonates presented within 5 days of age .118(61.7%) were more 36 weeks gestational age. 117(57.6%) neonates were between 1.8 to 2.5kg. Premature rupture of membranes, hypertension, prolonged labours, diabetes mellitus, oligohydramnios and bleeding per vagina were main associated antenatal and postnatal problems in our series. 127(67%) of our neonates were on formula feeding which is one of the contributing risk factors in our series. NEC was main culprit for pneumoperitoneum in 65(47.79%) neonates followed by HD, Atresia, meconium ileus, anorectal malformations, Malrotation and perforated Meckel`s diverticulum etc. Conclusion: We conclude that pneumoperitoneum is associated with high mortality and morbidity in neonates due to prematurity, low birth weight, formula feeding and improper medical and surgical management. The early diagnosis, recognition of contributing factors, prompt management and preventive measures are needed to decrease mortality and morbidity.

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