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[Treatment and results in necrotizing enterocolitis in infancy (author's transl)]
Insights
Necrotizing enterocolitis in infants often requires surgery, with a high mortality rate, especially when complicated by congenital malformations. Early surgical intervention improves outcomes for some neonates with intestinal perforation.
Area of Science:
- Pediatric Surgery
- Neonatal Gastroenterology
- Infectious Diseases
Background:
- Enteritis with complications poses significant risks to infants.
- Necrotizing enterocolitis (NEC) is a severe condition in newborns.
- Bacterial infections are frequently observed in affected infants.
Purpose of the Study:
- To analyze treatment outcomes for infants with enteritis and complications.
- To evaluate the efficacy of surgical interventions for NEC.
- To identify factors influencing prognosis in pediatric enteritis.
Main Methods:
- Retrospective analysis of 29 pediatric cases of enteritis with complications.
- Surgical intervention for diffuse peritonitis or radiological evidence of perforation.
- Specific surgical technique: resection with ostomy, followed by anastomosis.
Main Results:
- 27 out of 29 infants required surgery; 13 survived.
- Conservative treatment was successful in only 2 cases.
- 19 patients had bacteria detected in stool samples.
- 12 infants had concurrent heart and lung malformations, worsening prognosis.
Conclusions:
- Surgical management is often necessary for complicated enteritis and NEC in infants.
- High mortality rates persist, particularly with co-existing congenital anomalies.
- Prompt surgical intervention is critical for intestinal perforation in neonates.
Abstract:
29 children aged between 1 day and 22 months were treated for enteritis with complications. 2 children were cured conservatively. In 27 cases surgery was needed; of these 13 children survived. In 19 patients bacteria were found in the stools. Operation was indicated when there was diffuse peritonitis or when perforation could be shown radiologically. In cases of intestinal perforation the following technique was used in the last few years: 1. resection of the segment involved and ileoor colostomy. 2. Anastomosis and closure of colostomy 4--6 weeks later. Among 29 children with necrotizing enterocolitis there were 12 who also had malformations of the heart and lungs. This made worse a prognosis which was bad anyway.