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Related Experiment Videos

[Intestinal necrosis in children].

P Martins1, J Goulão, R Duarte

  • 1Departamento de Cirurgia, Hospital de Dona Estefânia, Lisboa.

Acta Medica Portuguesa
|March 10, 2001
PubMed
Summary
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Necrotizing enterocolitis, a serious intestinal condition, can affect children, even those without prematurity. Early surgical intervention and advanced diagnostics are crucial for managing this severe gastrointestinal disease.

Area of Science:

  • Gastroenterology
  • Pediatric Surgery
  • Pathology

Background:

  • Necrotizing enterocolitis (NEC) is a severe gastrointestinal condition primarily affecting premature neonates, characterized by intestinal ischemia and often infection.
  • While rare in older children and adults, NEC can occur in non-premature neonates and children with specific underlying health issues.
  • Identifying the precipitating factors for intestinal necrosis can be challenging.

Observation:

  • The study presents two cases of children (7 and 11 years old) with acute abdominal conditions and shock, diagnosed with necrotizing enterocolitis.
  • One child had chronic neutropenia, while the other had severe cognitive impairment and dysmorphic features.
  • Both cases required extensive intestinal resection (jejunal or colonic) and resulted in death due to multiple system organ failure despite surgical and medical interventions.

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Findings:

  • The cases illustrate necrotizing enterocolitis of the child, with one case diagnosed as neutropenic enterocolitis.
  • Etiopathogenic mechanisms reviewed include thrombotic, obstructive, inflammatory, non-occlusive ischemic, and infectious factors.
  • Necropsy revealed extensive necrosis of the remaining intestine in both patients.

Implications:

  • Early surgical intervention is critical for managing necrotizing enterocolitis in children.
  • Advanced diagnostic and therapeutic technologies, such as intestinal fatty acid-binding protein assays and selective arteriography, are valuable adjuncts.
  • Understanding the diverse etiologies and clinical presentations of NEC is essential for improving patient outcomes.