Acidosis and hepatic portal venous gas: indications for surgery in necrotizing enterocolitis

A retrospective review of cases of necrotizing enterocolitis seen at the Children's Hospital National Medical Center during the past 5 years was performed to identify factors that indicate a need for surgical intervention. The study group consisted of 92 neonates. Persistent acidosis and hepatoportal venous gas were significantly more common in babies requiring surgery than in those who were managed medically. Other physical, radiologic, and laboratory factors did not occur more frequently in those children going to surgery. Neonates with hepatoportal venous gas or persistent acidosis should be treated aggressively, and surgical intervention should be considered early in this group. Such an approach may serve to reduce morbidity and mortality in the future.