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At least 19 recordsLinked to original sources
PubMed1994

Pseudomembranous enterocolitis and hemorrhagic necrotizing enterocolitis in Hirschsprung's disease.

From 1977 to 1991, we encountered 67 patients with Hirschsprung's disease and 14 of them developed enterocolitis, with 3 cases being fatal. Enterocolitis occurred preoperatively in 12 infants, as well as after ileostomy in one and after a pull-through procedure in another. Seven infants had severe enterocolitis, including three with pseudomembranous enterocolitis and four with hemorrhagic necrotizing enterocolitis. Enterocolitis in Hirschsprung's disease mainly occurs due to intestinal obstruction and ischemia; however, in some cases, Clostridium difficile overgrowth and its toxin also appears to be related to severe pseudomembranous enterocolitis. In severe enterocolitis, antibiotics and enterostomy often prove to be ineffective, and thus an early resection of the affected bowel appears to be necessary. Moreover, when the aganglionic segment extends to the small bowel, severe enterocolitis tends to occur in the aganglionic intestine even after performing an enterostomy, and a resection of the aganglionic bowel is therefore recommended to allow for adequate lavage of the segment distal to the enterostomy site.

Enterocolitis, Pseudomembranous↗
PubMed2000

Enteral antibiotics for preventing necrotising enterocolitis in low birthweight or preterm infants.

BACKGROUND: Necrotising enterocolitis continues to be a problem, particularly in preterm neonates. There have been reports published suggesting that the use of enteral antibiotics may be effective as prophylaxis. This systematic review was undertaken to clarify the issue. OBJECTIVES: To evaluate the benefits and harms of enteral antibiotic prophylaxis for necrotising enterocolitis in low birth weight and preterm infants. SEARCH STRATEGY: Searches were made of the Oxford Database of Perinatal trials, MEDLINE (search terms: necrotizing enterocolitis, antibiotics; LIMITS: newborn infant), previous reviews with cross references, abstracts, conference and symposia proceedings, expert informants and journal handsearching in the fields of Neonatal Pediatrics and Microbiology. SELECTION CRITERIA: All randomized or quasi-randomized controlled trials where enteral antibiotics were used as prophylaxis against NEC in LBW (<2500g) and/or preterm (<37 weeks gestation) infants. DATA COLLECTION AND ANALYSIS: The standard method of the Cochrane Collaboration and its Neonatal Review Group was used. The methodological quality of each trial was reviewed by the second author who was blinded to the trial authors and institutions. Each author extracted data separately before comparison and resolution of differences. Relative risk (RR), risk difference (RD), and number needed to treat were used in the analysis. MAIN RESULTS: The administration of prophylactic enteral antibiotics resulted in a statistically significant reduction in NEC [RR 0.47 (0.23, 0.98); RD -0.072 (-0.136, -0.008); NNT 13.9 (7.4, 125)]. There was a reduction in NEC-related deaths which was of borderline statistical significance [RR 0.16 (0.02, 1.26); RD -0.097 (-0.183, -0.010); NNT 10.3 (5.46, 100)]. There were no significant differences in all deaths (one trial only) or in NEC-like enteropathies (one trial only). There was a statistically significant increase in the incidence of colonisation with resistant bacteria [RR 1.73 (1.00, 2. 97); RD 0.123 (0.008, 0.238); NNT 8.1 (4.2, 125)]. REVIEWER'S CONCLUSIONS: There is insufficient evidence to support the use of enteral antibiotic prophylaxis for NEC in clinical practice. To address this question further, a large trial would be required with a sample size sufficient to examine all the important benefits and harms. Adverse outcomes associated with infection, particularly with resistant bacteria, should be evaluated.

Anti-Bacterial Agents↗
PubMed1995

[A pathological comparison between Hirschsprung's enterocolitis and neonate necrotizing enterocolitis].

Autopsy records of 9 cases of neonate Hirschsprung's enterocolitis (HD) and 16 cases of neonate necrotizing enterocolitis (NEC) were analysed. It was found that the NEC lesions were more extensive than HD lesions, the bleeding and inflammation in NEC were also more serious than in HD. From our 21 animal experiments in which we tried to clarify the pathogenesis of Hirschsprung's enterocolitis and NEC, our preliminary hypothesis fro the development of Hirschsprung's enterocolitis being: the distal segment was first obstructed, causing the proximal segment to expand, the increase of pressure within the bowel resulted in ischemia of the intestines, increased bacterial multiplication in the retained feces and bacterial infiltration of the intestinal mucosa. The above being the major cause of HD. When the neonate is in asphyxia or shock, ischemia of the intestines and immunoallergic reactions occur, due to the lack of IgA in the mucosa, the multiplication and infiltration of pathogenic enterobacteria in the intestinal wall results in NEC.

Animals↗
PubMed1989

[Postoperative enterocolitis and current status of MRSA enterocolitis--the result of a questionnaire survey in Japan].

There is a trend of increase in the number of Staphylococcus aureus infection recently, and postoperative enterocolitis due to methicillin resistant strains is appearing. Because of this, a nation wide questionnaire survey on postoperative enterocolitis was conducted to clarify the status since 1980. Of the 875 major surgical institutes to which we sent the questionnaire, 370 (42.3%) replied and 67 case reports were obtained from 25 institutes. Twenty published reports were added to this and a total of 87 cases were evaluable. The number of postoperative enterocolitis increased after the year 1985, and those resulting from MRSA infection were more frequent in the northern half of Japan including the Kanto area. It was more frequent in males and the mean age was 57.9. Their onset was sudden, beginning with diarrhea and/or fever between the second and fifth postoperative days. In most of the cases, the cephalosporin group of antibiotics, especially of the third generation, were administered preceding the enterocolitis. Six of cases (24%) did not survive, and in some of the institutes they were considered to be hospital infections, as they appeared consecutively between a short period of time.

Adult↗
PubMed1997

[The drug sensitivity of enterohemorragic Escherichia coli and antibiotics treatment for hemorrhagic enterocolitis--from an outbreak of enterocolitis in Sakai city].

In July, 1996, a massive outbreak of hemorrhagic enterocolitis involving more than 5,000 people was caused by enterohemorragic Escherichia coli (EHEC) O157:H7 occurred mainly among elementary school children of Sakai City, Japan. The antibacterial activities in vitro against EHEC from stool specimens were determined. Norfloxacin showed the highest antibacterial activity, and fosfomycin, kanamycin, ampicillin, cefaclor were considered as effective drugs. But doxycycline showed lower antibacterial activities compared to other examined drugs, and it appears necessary to take antibiotic resistance of Escherichia coli into consideration when a treatment regimen is determined. As a result of the oral administration of fosfomycin to 95 patients of hemorrhagic enterocolitis and carrier, no patients developed complications with hemolytic uremic syndrome (HUS). However, a study of 17 patients with HUS demonstrated the fact that most of them were subjected to intravenous administration of fosfomycin. It may be needed to consider oral administration route of effective antibiotics in the treatment of enterocolitis in order to maintain high concentrations of a drug in the intestine.

Administration, Oral↗
PubMedDate not supplied

Clinical risk factors of Hirschsprung-associated enterocolitis. I: Preoperative enterocolitis.

Enterocolitis is still the main source of mortality and morbidity in Hirschsprung's disease (HD). Between 1976 and 1993, 79 (26%) of 302 Hirschsprung patients proved to have Hirschsprung-associated enterocolitis (HAEC). Mortality was 7.6 percent (6 patients). HAEC patients, those who died of HAEC and those without HAEC were analyzed for differences in 34 parameters. The length of the aganglionic segment was found not to be a risk factor for HAEC, but early diagnosis and prompt treatment were found to decrease the occurrence of preoperative HAEC. Although we defined HAEC as foul-smelling, explosive diarrhea, some other symptoms and signs, such as abdominal distention on physical examination, vomiting, dehydration, and a history of nonspecific diarrhea were encountered with significant frequency. None of the patients had Down's syndrome. Sepsis was detected in all of the patients who died of HAEC. The severity of HAEC did not increase with the number of attacks of HAEC, and mortality was greater in the first three attacks. Differences in results between some series seemed to be related to differing definitions of HAEC.

Child↗
PubMedDate not supplied

Clinical risk factors of hirschsprung-associated enterocolitis. II: Postoperative enterocolitis.

Among 302 Hirschsprung patients diagnosed between 1976 and 1993, 213 patients who had undergone definitive operations for Hirschsprung's disease (HD) were reviewed for the occurrence of postoperative Hirschsprung-associated enterocolitis (HAEC). The role of 42 parameters were analyzed. We detected 34 patients (14.0%) with postoperative HAEC with no mortality. In nine patients (26.5%) HAEC persisted postoperatively but no effect of preoperative HAEC on postoperative HAEC was detected. The length of the aganglionic segment did not have any effect on HAEC. Down's syndrome was not present in any of our patients with HAEC. Enterocolitis appeared after Swenson, Duhamel and Boley operations in 23, 10 and one patient, respectively. The incidence of HAEC was inversely proportional to age and weight at the time of definitive operation. The presence of colostomy before or during definitive operation had no effect on postoperative HAEC. Complications of definitive operations, including stricture, did not have any effect on HAEC.

Chi-Square Distribution↗
PubMed1994

Enterocolitis cystica profunda lesions in a patient with unclassified ulcerative enterocolitis.

Enteritis cystica profunda and diffuse colitis cystica profunda are exceedingly rare conditions. We report here the first case in which these two entities are associated in one patient. This 48-year-old woman presented initially with a solitary ulcer of the rectum and developed later deep ileal and colonic ulcerations with intervening normal mucosa, polypoid masses, and a dense fibrosis of the bowel wall. Colon and ileum specimens demonstrated submucosal mucous cysts and occasionally herniation of mucosal epithelium into the submucosa, which led to the diagnosis of enteritis and colitis cystica profunda. The exact nature of the underlying ileocolonic disease, which necessitated colectomy and extensive ileal resection, remained undetermined although an aggravating role of iterative surgical procedures is possible. Enteritis cystica profunda and diffuse colitis cystica profunda therefore seem to share a common pathogeny and have to be considered as lesions complicating an underlying disease rather than specific and autonomic diseases.

Cysts↗