The surgical treatment of enteritis necroticans

The optimum timing of surgery in acute cases of enteritis necroticans with bowel obstruction has not been established. Two similar groups of patients with this condition were sequentially compared to determine if early surgical intervention reduces mortality. In the first group 42 per cent of the 79 patients received medical treatment only and 58 per cent had an operation at a median time of 4 days following the onset of obstruction. In the second group 96 per cent of the 50 patients received surgery at a median time of 2 days following the onset of obstruction and 4 per cent received medical treatment only. The mortality in the second group (21 per cent) was half that of the first group (43 per cent). Surgery after a short period of resuscitation is advocated for all cases of enteritis necroticans with bowel obstruction.