P78.0

Clinical Causes: Meconium ileus, where thick, sticky meconium blocks the intestine Intestinal atresia or narrowing of the intestines Infections causing weakening of the intestinal wall Trauma during delivery that damages the intestine Vascular issues leading to poor blood supply and tissue death Congenital defects affecting intestinal development

Key Symptoms: Swelling or distension of the abdomen Bluish coloring of the abdominal skin or umbilical area Signs of abdominal tenderness or discomfort Respiratory difficulties due to pressure from distended abdomen Feeding difficulties or poor feeding Vomiting, potentially greenish if bowel obstruction occurs Absence of bowel movements or bowel sounds

Diagnosis Path: The diagnosis of perinatal intestinal perforation involves several steps. Medical teams typically review the baby's medical history and perform a physical examination. Imaging studies are crucial, especially abdominal X-rays, which may show free air or fluid indicating perforation. Ultrasound scans can help assess abdominal contents and detect fluid collections or inflammation. Laboratory tests may include blood counts and markers of infection or inflammation. Early diagnosis is vital to determine the appropriate surgical intervention and management plan.

Treatment Protocols: Treatment usually requires prompt surgical repair to close the perforation and remove damaged sections of the intestine. Before surgery, supportive care includes stabilizing the infant with intravenous fluids, antibiotics to prevent infection, and respiratory support if needed. Postoperative care involves monitoring for complications, ensuring adequate nutrition—often through parenteral nutrition—and managing infections. Long-term follow-up is essential to monitor for potential intestinal problems or growth issues associated with the condition.