Surgery for neonatal necrotising enterocolitis in Ireland 1980-1985

Forty-seven infants were operated on for necrotising enterocolitis (NEC) in Ireland in a 6-year-period from 1980 to 1985. Incidence for surgical NEC in Ireland is 1/8733 live births. 44/47 patients were operated on during the acute phase and 3 patients had elective resection of strictures following conservative management. Indication for surgery in the acute phase was pneumoperitoneum in 37 infants. The initial procedure was: drainage alone in 10 patients, laparotomy and defunctioning enterostomy in 18, resection of the necrotic segment and proximal enterostomy in 15. 27/44 acute patients survived giving an overall mortality of 38.6% for acute NEC but mortality directly related to NEC was 31.8%. There was an inverse relationship between mortality and age at surgery. Medical treatment included total parenteral nutrition (TPN) in all patients for a mean time of 20.5 days.