Late onset bowel stenoses after neonatal necrotizing enterocolitis

In 14 cases of bowel stenoses occurring after neonatal necrotizing enterocolitis (NEC), eight cases presented early, within 8 weeks from the onset of NEC and three beyond 4 months. In the other three cases the stenoses occurred in defunctionalized loops. The late onset stenoses remained undiagnosed until they presented with acute, life-threatening complications, and one of these patients died. We draw attention to these late onset stenoses which could be missed in early contrast studies, and recommend a study at 4 months rather than at 4 weeks, as previously recommended. Those presenting early should not be missed, as all of our cases presented with acute and obvious intestinal obstructions, and they were all still in hospital or undergoing frequent review.