[Intermittent peritoneal lavage following generalized peritonitis in the neonatal period and infancy].

Between 1981 and 1985, 15 neonates and young infants, who suffered from severe putrid or faecal peritonitis due to perforation of the gastrointestinal tract, were treated by intermittent postoperative peritoneal lavage. During the operation 2 to 4 drains were inserted into the peritoneal cavity. Immediately after operation peritoneal lavage was started with 20 ml/kg body weight Ringer or peritoneal dialysis solution. Inflow of the solution was done during a 20 minutes period. The solution then remained in the peritoneal cavity for another 20 min., before the 20 min. outflow was started (tidal-like rhythm). We did not use antibiotics or antiseptics in addition to the saline fluid to prevent damage to the tissue and adhesions of the bowel. Serum electrolytes, blood urea and body temperature can be changed by variation of the solution. After the operation the patients must remain in the intensive care unit. Accurate and detailed documentation of the balance of the inflow and outflow is very important. Five of the fifteen treated infants died due to additional malformations and complications following sepsis. All of them were premature with necrotising enterocolitis. Our experience with intermittent peritoneal lavage in selected patients suggest to use it in the management of infants with severe peritonitis due to perforation of the intestine.