The surgical management of neonatal necrotizing enterocolitis, 1975-1984

Abstract

A review was conducted of 202 neonates with necrotizing enterocolitis (NEC) seen at the Royal Children's Hospital, Melbourne, over a 10-year period. The study population was biased towards the more severe cases and those requiring surgical intervention for complications. Most cases had one or more obstetric or perinatal stress factors present. Radiology was important in confirming the diagnosis and identifying those who required surgery. The indications for surgical intervention and the selection of the appropriate surgical procedure are discussed. Surgery was required for acute disease in 72 cases. In most of these, necrotic bowel was excised and temporary ostomies constructed. During the period of study the overall mortality decreased from 41% to 24%. Post-NEC strictures occurred in 18 patients, of whom 6 presented with bowel obstruction. The transverse and left colon seemed particularly susceptible to stricture formation. The diagnosis and management are described in detail. © 1986 Springer-Verlag.