Treatment for necrotizing enterocolitis perforation in the extremely premature infant (weighing less than 1,000 g)

The frequency of necrotizing enterocolitis (NEC) in the extremely premature infant (less than 1,000 g) is still high and it is very difficult for infants weighing less than 1,000 g with NEC perforation to survive. In our institutes, the management protocol for NEC perforation in infants weighing less than 1,000 g includes peritoneal drainage under local anesthesia, administration of coagulating factor XIII, and the usual treatment for septic shock. During the past 3 years, four infants weighing less than 1,000 g with NEC perforation have survived using this protocol without laparotomy. This management protocol is the treatment of choice in infants in very poor condition or infants weighing less than 1,000 g with NEC perforation.