A fresh look at necrotizing enterocolitis

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. ARTICLE PDF AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Columbia Univ. Col. Phys. & Surg.,

Depts. Ped. and Surg., and Babies Hospital, New York City Richard A Polin, Paul F Pollack, Barbara Barlow, Thomas V Santulli & William C Heird Authors * Richard A Polin View author

publications You can also search for this author inPubMed Google Scholar * Paul F Pollack View author publications You can also search for this author inPubMed Google Scholar * Barbara

Barlow View author publications You can also search for this author inPubMed Google Scholar * Thomas V Santulli View author publications You can also search for this author inPubMed Google

Scholar * William C Heird View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS

ARTICLE 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 Download citation

* Issue Date: 01 April 1974 * DOI: https://doi.org/10.1203/00006450-197404000-00266 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get

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