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  • Letter to the Editor
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Reply to Drs Skerritt, Modi and Clarke

Journal of Perinatology volume 28, pages 238–239 (2008)Cite this article

We greatly appreciate the letter from Drs Skerritt, Modi and Clarke, because the most important goal of our review1 was to stimulate dialogue across disciplines. It is obvious that two pediatric surgeons and a neonatologist did exactly that in drafting their letter. We are also gratified to learn that our arguments favoring the necessity of an alternative to Bell's staging was well received. Hopefully this exchange is the beginning of a cordial and constructive debate that will reverberate throughout the neonatal and pediatric surgery communities over the next couple of years.

One of the reasons we proposed ‘guidelines’ rather than criteria was because there could be appropriate diagnostic discretion at the bedside. That is also the reason for such an exhaustive list of variables. Not that every variable will be ticked off and tallied, but each will be considered by the informed clinician and a ‘best fit’ diagnosis will be assigned based on all available and relevant data. In a prospective study, Blakely et al.2 were able to correctly diagnose NEC versus SIP 95% of the time in extremely low birth weight patients who subsequently got laparotomy, so it is clearly feasible to use bedside diagnostic criteria for some of the ANIDs.

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Figure 1

References

  1. Gordon PV, Swanson JR, Attridge JT, Clark R . Emerging trends in acquired neonatal intestinal disease: is it time to abandon Bell's criteria? J Perinatol 2007; 27: 661–671.

    Article  CAS  Google Scholar 

  2. Blakely ML, Lally KP, McDonald S, Brown RL, Barnhart DC, Ricketts RR et al. Postoperative outcomes of extremely low birth-weight infants with necrotizing enterocolitis or isolated intestinal perforation: a prospective cohort study by the NICHD Neonatal Research Network. Ann Surg 2005; 241: 984–989.

    Article  Google Scholar 

  3. Sharma R, Garrison RD, Tepas D, Mollitt DL, Pieper P, Hudak ML et al. Rotavirus-associated necrotizing enterocolitis: an insight into a potentially preventable disease? J Ped Surg 2004; 39: 453–457.

    Article  Google Scholar 

  4. Sharma R, Hudak ML, Premachandra BR, Stevens G, Monteiro CB, Bradshaw JA et al. Clinical manifestations of rotavirus infection in the neonatal intensive care unit. Pediatr Infect Dis J 2002; 21: 1099–1105.

    Article  Google Scholar 

  5. Hintz SR, Kendrick DE, Stoll BJ, Vohr BR, Fanaroff AA, Donovan EF et al. Neurodevelopmental and growth outcomes of extremely low birth weight infants after necrotizing enterocolitis. Pediatrics 2005; 115: 696–703.

    Article  Google Scholar 

  6. Adesanya OA, O'Shea TM, Turner CS, Amoroso RM, Morgan TM, Aschner JL . Intestinal perforation in very low birth weight infants: growth and neurodevelopment at 1 year of age. J Perinatol 2005; 25: 583–589.

    Article  Google Scholar 

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Authors and Affiliations

  1. University of Virginia Children's Hospital, Charlottesville, VA, USA

    P V Gordon, J R Swanson & J T Attridge

  2. Pediatrix Medical Group Inc, Greenville, SC, USA

    R Clark

Authors
  1. P V Gordon
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  2. J R Swanson
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  3. J T Attridge
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  4. R Clark
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Correspondence to P V Gordon.

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Gordon, P., Swanson, J., Attridge, J. et al. Reply to Drs Skerritt, Modi and Clarke. J Perinatol 28, 238–239 (2008). https://doi.org/10.1038/sj.jp.7211893

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