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PubMed · 6662689

Necrotizing enterocolitis--a 5-year experience.

Abstract

With the increased survival of very-low-birth-weight neonates, necrotizing enterocolitis (NEC) represents one of the most frequent life-threatening conditions for this population. NEC was diagnosed on 24 occasions during a 5-year period (1977-81) at the Neonatal Intensive Care Unit, Kaplan Hospital, Rehovot. These 24 NEC cases, confirmed by radiological, surgical or pathological findings, were analyzed in a retrospective study. The mean weight was 1,450 g and the mean gestational age 32 weeks. Only one of the affected infants was a full-term newborn. The mean age at onset of symptoms was 9.8 days. In one case, NEC developed before feedings were started. The infectious agents--most frequently gram-negative rods--were isolated from the most seriously ill babies. Cultures from blood and gastric aspirate were positive in 10 of the 12 fatal cases. No bacteria were isolated from the blood among the survivors. Rotavirus, the only viral particle detected, was diagnosed in the bloody stools of two of the infants who recovered completely. Prophylactic therapy with oral kanamycin, administered to all premature infants weighing less than 1,500 g born over a 3-year period, did not appear to have a preventive influence. The overall mortality was 50%, with no sequelae observed among survivors. The high incidence of positive cultures among fatal cases suggests that overwhelming infection played a fundamental role in the outcome.

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BibTeXRIS

B M Mogilner, A Shanon. 1983. Necrotizing enterocolitis--a 5-year experience.. https://pubmed.ncbi.nlm.nih.gov/6662689/

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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.

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