Laparocentesis for Critically Ill Neonates with

Perforated Necrotizing Enterocolitis

G. Kh. Aghayev

Scientific Research Institute of Pediatry,

Baku, Azerbaijan
Background: The usual treatment of complicated neonatal
necrotizing enterocolitis is resection of the necrotic bowel,
lavage of the peritoneal cavity and diversion enterostomy.
Critically ill patients with this condition are in special danger if
general anesthesia and full exploratory surgery performed.
Methods: A relatively simple alternate procedure is insertion of
two soft abdominal drains through laparocentesis under local
anesthesia, most often in the right lower quadrant. In recovered
patient we did two incision: first in right lower quadrant, second
- in the left upper quadrant after four days due to air collection
in this area of the abdominal cavity. The procedure was done in
the neonatal intensive care unit without moving the whole set-
up to the operating room.
Results: 4 cases were treated in the last year. One patient was
discharged home as they did not require additional surgical
treatment, not having developed intestinal stenosis or
obstruction. 3 died due to a severe sepsis, intraventricular
hemorrhage and respiratory failure 1 to 3 days after the
procedure.

Conclusions: Our limited experience encourages us to

recommend abdominal drainage through laparocentesis in the
very sick neonates with fulminant NEC.