Intestinal perforations in infants with a very low birth weight: a disease of increasing survival?

Seventeen infants with a very low birth weight (VLBW) and spontaneous, non-necrotizing enterocolitis (NEC), intestinal perforations are presented; 14 of them were seen in the past 3 years. A comparison with 16 surgically treated NEC infants (< 1,000 g) is provided. At our institution, the yearly survival of VLBW infants increased from 54% to 90% over the past 6 years. All 17 non-NEC patients were operated on, and 15 (88.2%) survived. Ileal perforations were observed frequently. Initial enterostomies were followed by reanastomosis at an average age of 3 months. A 22.6-month follow-up was attained for all survivors. Non-NEC intestinal perforations in tiny neonates are increasing and constitute a challenging but treatable group. The improving survival rate of VLBW infants will probably be accompanied by a variety of complications.