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Enteric fistulas and necrotizing enterocolitis

M D Stringer1, E Cave, J W Puntis

  • 1Department of Paediatric Surgery, Leeds General Infirmary, England.

Journal of Pediatric Surgery
|September 1, 1996
PubMed
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Internal enteric fistula is a rare complication of necrotizing enterocolitis (NEC). This study found it occurs in 4% of NEC cases and is often linked to strictures and sepsis, with surgical resection offering a chance of survival.

Area of Science:

  • Neonatalogy
  • Pediatric Surgery
  • Gastroenterology

Background:

  • Necrotizing enterocolitis (NEC) is a serious gastrointestinal condition in infants.
  • Internal enteric fistula is a rare but significant complication of NEC.

Purpose of the Study:

  • To examine the incidence, presentation, significance, and outcomes of internal enteric fistula formation secondary to NEC.
  • To understand the clinical course and management of infants with NEC-associated enteric fistulas.

Main Methods:

  • Retrospective review of 130 infants with NEC over a 7-year period.
  • Analysis of clinical data, radiographic findings, surgical interventions, and outcomes.
  • Diagnosis of fistulas confirmed by contrast radiology.

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Main Results:

  • Five infants (4%) developed enteric fistulas following NEC.
  • Fistulas were associated with intestinal necrosis, strictures, inflammatory masses, and sepsis.
  • Surgical resection was performed in four patients; two survived with limited resection, one developing short bowel syndrome.

Conclusions:

  • Internal enteric fistula is a rare complication of NEC, often presenting with strictures and sepsis.
  • Surgical management can be successful, but carries a significant risk of short bowel syndrome.
  • Early diagnosis and intervention are crucial for improving outcomes in these complex cases.