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 studywas 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
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 measuresare needed to decrease mortality and morbidity.
Key words: Neonate, Pneumoperitoneum, Outcome, Risk