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Necrotizing enterocolitis: a chronic colonic disease.

S Z Rubin, J D Kenney, D D McMillan

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |March 1, 1985
    PubMed
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    Necrotizing enterocolitis (NEC) can lead to chronic issues like strictures, even after initial survival. Long-term complications, including "short gut syndrome," affect survival rates in neonates.

    Area of Science:

    • Neonatal Medicine
    • Pediatric Surgery
    • Gastroenterology

    Background:

    • Acute necrotizing enterocolitis (NEC) is a prevalent neonatal condition.
    • The chronic sequelae of NEC are frequently underestimated.
    • Long-term outcomes require careful consideration beyond the acute phase.

    Purpose of the Study:

    • To investigate the long-term consequences of NEC in infants.
    • To analyze the incidence and characteristics of colonic strictures post-NEC.
    • To inform management strategies for infants surviving NEC.

    Main Methods:

    • Retrospective review of 211 infants diagnosed with NEC between 1979 and 1983.
    • Analysis of infants requiring surgical intervention versus medical management.
    • Assessment of long-term survival and development of complications like strictures.

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    Main Results:

    • Overall survival was 98% for the acute episode and 92% long-term.
    • Late deaths were attributed to chronic cardiovascular, pulmonary, cerebral diseases, and short gut syndrome.
    • Colonic strictures occurred in 9% of medically treated and 50% of surgically treated infants, often requiring intervention and not resolving spontaneously.

    Conclusions:

    • Infants surviving NEC face risks of chronic complications, notably colonic strictures.
    • Surgical intervention for NEC is associated with a higher incidence of strictures.
    • Understanding the chronicity and varied presentation of NEC sequelae is crucial for appropriate infant management.