Laparoscopic localization and microlaparotomy for focal isolated perforation in XXXX : an alternative approach to a challenging problem.

@entity1 @entity3166 @entity66 @entity254 @entity29 @entity516
BACKGROUND: @entity3166 has a wide clinical spectrum of manifestation. We report a novel method of managing focal isolated perforation in @entity3166 by using diagnostic laparoscopy to localize the site of perforation and by making a microincision over the perforation to perform exteriorization or limited resection and primary @entity254 . METHODS: We included low-birth weight @entity1 presenting with sudden clinical deterioration and @entity516 . @entity1 with gross abdominal wall signs were excluded on the probability that they had extensive disease. Diagnostic laparoscopy was performed using a 3.5-mm trocar and 1.9-mm telescope. A 1-cm incision was made over the site of perforation, and local surgical debridement was performed. RESULTS: There were 3 extremely low-birth weight @entity1 (580, 700, and 780 g) and 1 larger @entity1 (1.6 kg). In all cases, an isolated perforation was detected. None had @entity66 . The 3 smaller @entity1 had exteriorization and enterostomies. The larger @entity1 had resection and primary @entity254 . All @entity1 recovered uneventfully. CONCLUSION: Diagnostic laparoscopy can be safely performed in extremely low-birth weight @entity1 . It allows precise identification of the site of perforation to perform a limited microlaparotomy at this site, significantly reducing the surgical @entity29 . We report a novel method of managing this vexing problem.
