PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 3508627

Neonatal necrotizing enterocolitis in Lagos.

S D Adeyemi·I Ahmed
View original source ↗Export metadata ↓

Abstract

The records of 14 infants in whom the diagnosis of Neonatal Necrotizing Enterocolitis was made between 1978 and 1984 were studied. The distance appeared in the second week of life of the majority (57%) of the babies, and was equally prevalent in preterm and term babies. Infections seemed to be the predisposing factor in all cases although no transmissable pathogens were identified. Abdominal distention (57%), rectal bleeding (21%) and bowel perforation (14%) were the main presenting features. The only three survivors were among the babies treated medically including intravenous metronidazole. The only baby that survived bowel resection succumbed three months later to jejunostomy diarrhoea. Extended medical management including intravenous metronidazole is being suggested as the treatment for acute NNEC in developing countries while surgical treatment is reserved only for perforation and uncontrollable rectal bleeding.

Explore related subjects

Enterocolitis, PseudomembranousFemaleHumansInfant, NewbornMaleNigeriaJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

S D Adeyemi, I Ahmed. 1986. Neonatal necrotizing enterocolitis in Lagos.. https://doi.org/10.3109/00365528609093793

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2002

Epidemiology and outcome of "early-onset" vs "late-onset" necrotizing enterocolitis.

OBJECTIVE: We hypothesized that among neonates with necrotizing enterocolitis (NEC), important epidemiologic and outcome differences exist between those with early-onset vs. those with late-onset NEC. METHODS: We reviewed all records of neonates cared for in the King Fahad University Hospital during the past ten years who had the diagnosis of NEC. We separated cases into two groups depending on age at diagnosis. Specifically, we termed "early-onset" those cases diagnosed during the first seven days of life, and "late-onset" those diagnosed thereafter. We compared, in the two groups, gestational age, clinical signs at onset, laboratory data, surgical findings, complications, and mortality. RESULTS: From 1989 to 1999, 37 cases of stage IIa (or higher) NEC were diagnosed; 25 "early-onset" and 12 "late-onset". Neonates with "early-onset" NEC were more mature (35.4 +/- 2.5 weeks gestation) than those with "late-onset" (27.7 +/- 2.8 weeks, P=0.0001), were more likely to have feedings begun in the first 48 hours of life (P = 0.0002), and more likely to have feeding increments of >25 ml/kg/day (P=0.03). Neonates with "late-onset" NEC were more likely to present with vomiting (P=0.003) and apnea (P=0.001), and were more likely to have ileal rather than colonic necrotic lesions, short bowel syndrome, and mortality (P=0.03). CONCLUSION: During the past 10 years at the King Fahad University Hospital, cases of early- and late-onset NEC have had distinct epidemiologic and outcome features. Recognizing these differences may be useful in prognostication and counseling.

Enterocolitis, Pseudomembranous↗
PubMed2002

Recurrent pseudomembranous colitis as a cause of recurrent severe sepsis.

Clostridium difficile (C. difficile) colitis accounts for nearly 15-20 % of antibiotic-associated diarrhea. Manifestations include asymptomatic carriage, self-limited diarrhea, and pseudomembranous colitis, which is sometimes life-threatening. Despite effective therapy with metronidazole and vancomycin relapse rates are 15-33 %. Although colitis is seen in critically ill patients treated with combinations of broad-spectrum antibiotics, reports describing severe sepsis as a result of C. difficile infection are limited. We describe the case of recurrent severe sepsis due to recurrent local intestinal C. difficile infection as the only identifiable etiology. The mechanism of severe sepsis may be a derangement of the gastrointestinal barrier function. This could result in absorption of microbes or endotoxin or activation of inflammatory cascades in the submucosa of the intestine or liver. In general, for successful treatment of C. difficile infections other than anticlostridial antibiotics should be discontinued. However, in the present case bacterial translocation from the intestine is an attractive explanation for severe sepsis and therefore additional antibiotics had been administered.

Enterocolitis, Pseudomembranous↗