Spontaneous Intestinal Perforation (SIP)
Overview
Spontaneous intestinal perforation – or SIP – refers to when a hole occurs in a baby’s intestine during or soon after fetal development for no known reason. The hole can cause the intestine contents to leak into their abdomen (belly), which can lead to a serious infection known as peritonitis (inflammation of the abdomen lining). SIP is a surgical emergency and once diagnosed, it should be treated as soon as possible.
Symptoms of SIP
Signs and symptoms of SIP can include:
Shock (life-threatening condition caused by decreased blood flow) symptoms, such as cold, clammy skin, rapid heart rate and irregular breathing
Vomiting
Constipation
Discoloration of skin on the belly
Distended (swollen) belly
Fever
Pulling legs up (due to abdominal pain)
Shivering (due to chills)
When to see a doctor
If your child shows any signs or symptoms of SIP, you should take them to the closest emergency department.
Causes of SIP
Experts don’t know what causes SIP.
Who’s at risk
Babies born at 36 weeks of pregnancy or earlier (“preemies”) or who have a very low birth weight are at an increased risk of being born with SIP.
Diagnosis of SIP
If your baby’s pediatrician (a doctor who specializes in treating children) suspects that they may have SIP, your baby may need one or more of the following tests:
Blood test. Testing your baby’s blood can show a high white blood cell count. This may indicate your baby has an infection due to the perforation (hole) in the intestines. White blood cells fight infection and other illness in the body.
X-ray. Your baby’s doctor may use X-ray imaging to get detailed pictures of your baby’s abdomen and locate the exact location of the perforation (hole).
Computerized tomography (CT) scan. This imaging test uses X-rays from several angles to create detailed pictures of your baby’s abdomen (belly) and locate the perforation's (hole’s) exact location.
Ultrasound. This test uses sound waves to create detailed images of the inside of your child’s body, and look for air or abnormal fluid outside the intestines.
Treatments for SIP
If your baby has SIP, they will need surgery to repair the perforation (hole) as soon as possible.
Surgery for SIP will be performed either in an operating room at Orlando Health Children's Arnold Palmer Hospital, or at your child’s bedside in the neonatal intensive care unit (NICU) at Orlando Health Winnie Palmer Hospital. During this procedure, your baby will be under general anesthesia (fully asleep). During surgery, your baby’s surgeon will repair the hole. Your baby will temporarily spend time in the neonatal intensive care unit (NICU) after surgery to ensure their intestines are working correctly.
Depending on your baby’s exact situation and location of the intestinal hole, they may need a temporary ileostomy or colostomy bag while their intestines heal. The bag connects the large intestine to an opening a surgeon makes in the abdomen. Ostomy bags collect your baby’s stool outside the body. If needed, your baby’s surgeon will attach the bag at the same time as surgery to repair the perforation. After a few months, your child should be able to pass stool normally, and a doctor can remove the colostomy bag and reconnect their intestines.
Home care after surgery
Your baby’s care team will advise you of any specialized diet or feeding needs for your baby. If your baby needs an ostomy bag, you will receive detailed instructions on caring for it by the nursing staff and the surgery team.
Contact Us
If you suspect that your child may have Perianal Abscess or Fistula, make an appointment with an Orlando Health pediatrician today so your child can start on the road to improved health.
