Abstract
Prematurity, asphyxia, infection, and feeding--singly or in combination--have been cited as etiologies of necrotizing enterocolitis. To further define the relative importance of each factor, the clinical courses of 55 patients seen between 1954 and 1973 were reviewed. In most cases the diagnosis of NEC was confirmed at operation or postmortem examination. Other patients included had radiographic evidence of intramural air in addition to other symptoms consistent with the diagnosis. Only 8 of the 55 patients had a gestational age greater than 38 weeks. Three of these had severe cyanotic CHD; others developed NEC at an older age (14-42 days) after a prolonged period of diarrhea. Antenatal complications were documented in 60% of the group; 26% had low Apgar scores and/or asphyxia. Forty infants had symptoms or signs of sepsis. Blood cultures were positive in 36 patients; in 97% of these, the isolated organism was a gram negative baccilus. Thrombo-cytopenia and/or abnormal clotting profiles were present in 72% of the patients. Abdominal x-rays were normal in only 4% of the patients; intramural pneumatosis was seen in 47%, free air in 23%, and non-specific abnormalities in the remainder. Every patient with intramural pneumatosis or free air, radio-graphically or on direct examination, had been fed. These findings suggest that all the cited factors play a role in development of NEC.
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Polin, R., Pollack, P., Barlow, B. et al. A FRESH LOOK AT NECROTIZING ENTEROCOLITIS. Pediatr Res 8, 384 (1974). https://doi.org/10.1203/00006450-197404000-00266
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DOI: https://doi.org/10.1203/00006450-197404000-00266