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Intestinal stricture after necrotizing enterocolitis

J S Janik, S H Ein, K Mancer

    Journal of Pediatric Surgery
    |August 1, 1981
    PubMed
    Summary
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    Necrotizing enterocolitis (NEC) can lead to intestinal strictures in infants, often requiring surgery. Early diagnosis and tailored treatment, including delayed reconstruction, improve outcomes for these neonates.

    Area of Science:

    • Pediatric Surgery
    • Gastroenterology
    • Neonatal Care

    Background:

    • Necrotizing enterocolitis (NEC) is a serious condition in neonates.
    • Intestinal strictures are a known complication following NEC.
    • Identifying risk factors and optimal management is crucial.

    Purpose of the Study:

    • To investigate the incidence and characteristics of intestinal strictures post-NEC.
    • To evaluate treatment outcomes and identify factors influencing morbidity and mortality.
    • To provide recommendations for diagnosis and management.

    Main Methods:

    • Retrospective review of neonates diagnosed with NEC between 1974-1979.
    • Analysis of stricture location, timing, and pathological findings.
    • Evaluation of surgical interventions and patient outcomes.

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    Main Results:

    • 20 of 175 neonates developed intestinal strictures 1-20 months after NEC.
    • Strictures were predominantly colonic (80%), with 15% being multiple.
    • Submucosal fibrosis was the main pathological feature, varying with lesion age.

    Conclusions:

    • Intestinal strictures occur in 6%-33% of infants with prior NEC.
    • High index of suspicion and barium enema are key diagnostic tools.
    • Complete resection or delayed reconstruction is recommended for optimal outcomes.