Comparison of preoperative and intraoperative surgeon diagnosis and pathologic findings in spontaneous intestinal perforation vs necrotizing enterocolitis.
Publication/Presentation Date
4-1-2024
Abstract
OBJECTIVE: To investigate the accuracy of preoperative and intraoperative diagnosis via comparison to pathologic diagnosis in spontaneous intestinal perforation (SIP) vs. necrotizing enterocolitis (NEC).
STUDY DESIGN: A retrospective review of neonates < 1500 g treated for pneumoperitoneum between 07/2004-09/2022 was conducted. Patients treated for NEC medically prior to diagnosis and those treated with drain only were excluded. Fleiss' Kappa analysis assessed agreement between all three diagnoses: preoperative, intraoperative, and pathologic.
RESULT: Overall, 125 patients were included with mean birthweight 834.2 g (SD:259.2) and mean gestational age 25.8 weeks (SD:2.2). Preoperative and intraoperative diagnoses agreed in 90.3%, intraoperative and pathologic agreed in 71.1%, and preoperative and pathologic agreed in 75.2% of patients. Fleiss' Kappa was 0.55 (95% CI:0.43,0.68), indicating moderate agreement between the three diagnoses.
CONCLUSION: Our study shows moderate agreement between preoperative, intraoperative, and pathologic diagnoses. Further studies investigating the clinical characteristics of SIP and NEC are needed to improve diagnostic accuracy and management.
Volume
44
Issue
4
First Page
568
Last Page
574
ISSN
1476-5543
Published In/Presented At
Keane, O. A., Dantes, G., Dutreuil, V. L., Do, L., Rumbika, S., Sylvestre, P. B., & Bhatia, A. M. (2024). Comparison of preoperative and intraoperative surgeon diagnosis and pathologic findings in spontaneous intestinal perforation vs necrotizing enterocolitis. Journal of perinatology : official journal of the California Perinatal Association, 44(4), 568–574. https://doi.org/10.1038/s41372-024-01876-9
Disciplines
Medicine and Health Sciences
PubMedID
38263461
Department(s)
Fellows and Residents
Document Type
Article