Abstract
100 infants between Aug.,1969, and Oct.,1976, with radiologic, surgical, and/or pathologic diagnosis of NEC since this institution's last report of 43 cases were analyzed, representing an incidence of 2-3% of all intensive care nursery admissions. Strict X-ray criteria were used to confirm the diagnosis: pneumatosis intestinalis(92 cases), hepatic portal venous gas (HPVG, 31), and pneumoperitoneum(12). 20% of cases were diagnosed after 2 weeks, the latest at 51 days. 30 infants with highly suggestive clinical signs for 24 or more hours had initial X-rays which were nondiagnostic. 4 intestinal perforations were not manifested by free gas on X-ray. The diagnosis was not made antemortem in 9. The overall mortality was 46% compared to 37% in the last series. 67 infants were managed medically, and 33 underwent surgery with mortalities of 37% and 64%, respectively. 18 who had operations were < 1400gms. None succumbed during surgery, and 9 were judged at the time of operation to have such extensive disease as to not warrant resection and/or diversion procedure. Failure of medical management (surgery and/or death) occurred in 58. Mortality was increased with low birth weight, low gestational age, HPVG, and surgery. Of 11 infants ≥2500gms, the mortality was 27%. Infants with confirmed NEC continue to have a high mortality, suggesting that advanced disease is already present when these strict criteria are met. Methods for early, reliable identification of infants at risk to develop NEC are needed to reduce the incidence, morbidity, and mortality of this condition.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Stevenson, D., Graham, C., Stevenson, J. et al. 1029 NEONATAL NECROTIZING ENTEROCOLITIS (NEC): 100 NEW CASES. Pediatr Res 12 (Suppl 4), 535 (1978). https://doi.org/10.1203/00006450-197804001-01035
Issue Date:
DOI: https://doi.org/10.1203/00006450-197804001-01035