Six-year retrospective analysis of colonic perforation in neonates and infants: Single centre experience

Abstract

Background: Developing countries at tertiary referral centre. This study analysed the aetiology of colonic perforation (CP) in neonates and infants.

Materials and Methods: Retrospective analyses of 60 CP cases (presented from May 2005 to May 2011) were done.

Results: The mean age at presentation was 8.33 ± 0.11 days (range, 2-110 days). The aetiology were Hirschsprung’s disease (HD), necrotising enterocolitis (NEC) and idiopathic perforation in 78.33% (47/60), 6.67% (4/60) and 15% (9/60), respectively. There were 210 patients with histopathologically proven HD; 22.38% (47/210) cases of HD had CP. Most common site of perforation was mid-transverse colon (74%, 35/47) in HD patients. All HD-associated mid-transverse colonic, caecal, appendicular and ascending colon perforations (except one caecal perforation) had aganglionic recto-sigmoid region and ganglionic perforation site. Features of enterocolitis were not found in any HD patients. Two patients (3.33%) died due to sepsis.

Conclusions: There was a high rate of primary HD-associated colonic perforation in this study. Colonic perforation may the initial presenting condition in HD disease. We advocate colonic biopsy to rule out HD in any neonate presenting with primary colonic perforation.

Key words: Colonic perforation, Hirschsprung’s disease, necrotising enterocolitis