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Necrotizing enterocolitis following operation in the neonatal period
L K Shanbhogue1, P K Tam, D A Lloyd
1Department of Child Health, University of Liverpool, UK.
The British Journal of Surgery
|September 1, 1991
Summary
Necrotizing enterocolitis (NEC) can occur in newborns after surgery, affecting 19% of NEC cases. Postoperative NEC requires careful consideration in neonates experiencing clinical deterioration.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
- Surgical complications
Background:
- Necrotizing enterocolitis (NEC) is a serious gastrointestinal condition in newborns.
- Postoperative NEC is a recognized but infrequent complication following neonatal surgical procedures.
Purpose of the Study:
- To determine the incidence and characteristics of necrotizing enterocolitis (NEC) in neonates following surgical intervention.
- To highlight the importance of considering NEC in the differential diagnosis of postoperative complications in neonates.
Main Methods:
- Retrospective review of 33 neonates who developed necrotizing enterocolitis (NEC) after surgery over a 16-year period.
- Analysis of patient demographics, surgical procedures, NEC treatment (operative vs. non-operative), and outcomes.
Main Results:
- 33 neonates developed postoperative NEC, representing 19% of all NEC cases during the study period.
- Commonly associated surgeries included myelomeningocele repair, intestinal atresia, gastroschisis, and diaphragmatic hernia repair.
- Most neonates (20/33) were treated non-operatively; 13 required further surgery for NEC complications. 23 patients survived with long-term follow-up.
Conclusions:
- Necrotizing enterocolitis (NEC) is a significant complication following neonatal surgery, occurring in 19% of NEC cases.
- Clinical deterioration after any neonatal operation warrants inclusion of NEC in the differential diagnosis.
- Prompt recognition and management are crucial for improving outcomes in neonates with postoperative NEC.