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Experience in 50 Infants and Children

Ann M. Kosloske, MD; Jane F. Goldthorn, MD

Arch Surg. 1982;117(5):571-575.

Abstract
• We performed paracentesis or peritoneal lavage on 50 seriously ill infants and children in whom the diagnosis of intestinal gangrene or perforation was suspected. Thirty-four infants had necrotizing enterocolitis and 16 had other conditions. In infants with suspected intestinal gangrene, the presence of brown peritoneal fluid and/or bacteria on Gram's stain was indicative of intestinal gangrene. In infants with pneumoperitoneum, the presence of cloudy fluid with leukocytosis was indicative of gastrointestinal perforation. Using these two criteria, the accuracy of paracentesis in predicting the need for operation was 90%. When combined with clinical judgment, the accuracy rose to 97.5%. The rate of negative findings from abdominal explorations was 5%. Analysis of the peritoneal fluid may improve the timing and accuracy of the operative decision.

(Arch Surg 1982;117:571-575)

Author Affiliations
From the Division of Pediatric Surgery, Department of Surgery, University of New Mexico School of Medicine, Albuquerque.

Footnotes
Accepted for publication Dec 28, 1981.

Read at the 89th annual meeting of the Western Surgical Association, Albuquerque, Nov 16, 1981.

Reprint requests to Department of Surgery, University of New Mexico School of Medicine, 2211 Lomas Blvd NE, Albuquerque, NM 87131 (Dr Kosloske).

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