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Published on: October 29, 2014
Colonic stricture following necrotizing enterocolitis
Insights
Necrotizing enterocolitis (NEC) survivors face increased risks of late complications, including colon strictures. This report details three neonates with colon strictures developing weeks after NEC, highlighting diverse presentations.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
- Gastrointestinal pathology
Background:
- Necrotizing enterocolitis (NEC) is a serious gastrointestinal condition in neonates.
- Advances in neonatal care have improved survival rates but increased focus on late complications.
- Colon strictures are a recognized, albeit less common, long-term sequela of NEC.
Observation:
- Three neonates developed colon strictures following an acute episode of NEC.
- Strictures appeared 3, 4, and 6 weeks post-NEC onset.
- Observed strictures varied in presentation, including extensive long segments and tight, short constrictions.
Findings:
- Colon strictures represent a significant late complication of NEC.
- The morphology of NEC-induced strictures can mimic other conditions like colonic atresia.
- Prompt identification of these strictures is crucial for appropriate management.
Implications:
- Increased awareness of NEC-related colon strictures is needed among neonatologists and pediatric surgeons.
- Diagnostic imaging and endoscopic evaluation are vital for characterizing these strictures.
- Timely surgical or endoscopic intervention may be required to manage obstructive symptoms and prevent further complications.
Abstract:
There has been a steady increase in the incidence of necrotizing enterocolitis (N.E.C.). Early diagnosis and prompt surgical intervention have improved the mortality considerably (8). With the increasing number of survivors, late complications are more frequently encountered. Three neonates who had developed strictures of the colon 3, 4 and 6 weeks respectively, after the onset of the acute episode of N.E.C. are reported and showed interesting features, an extensive long stricture and a tight short stricture which simulates a colonic atresia.
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