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Necrotizing enterocolitis in term neonates.

D A Andrews¹, R S Sawin, D J Ledbetter

¹Department of Surgery, Children's Hospital and Medical Center, Seattle, Washington.

American Journal of Surgery

|May 1, 1990

Summary

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Necrotizing enterocolitis (NEC) in term infants presents uniquely, often without typical risk factors and with early onset. Surgical intervention is frequently required, differing from NEC in premature infants.

Area of Science:

Neonatology
Pediatric Surgery
Gastroenterology

Background:

Necrotizing enterocolitis (NEC) is a serious intestinal disease primarily affecting premature infants.
While less common, NEC can also occur in full-term neonates, presenting distinct clinical characteristics.

Purpose of the Study:

To identify and analyze the unique features of NEC in term neonates.
To compare the presentation, clinical course, and outcomes of NEC in term versus premature infants.

Main Methods:

Retrospective review of 10 full-term neonates diagnosed with NEC between January 1984 and May 1989.
Analysis of patient charts for risk factors, clinical presentation, interventions, and outcomes.

Main Results:

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Term NEC cases often presented within the first 4 days of life, with 60% lacking common risk factors like asphyxia or respiratory distress.

Seven out of 10 patients required surgery, primarily for colonic perforation or peritonitis, with two undergoing total colectomy.

One mortality occurred in a patient with associated meconium ileus and NEC.

Conclusions:

NEC in term neonates exhibits distinct features compared to premature infants, including earlier onset and absence of typical risk factors.
Surgical management is frequently necessary for severe colonic disease in term neonates with NEC.
Outcomes for surgically treated term neonates were favorable, with successful intestinal reconstruction and no late complications.