| A Clinical Observation of 23 Cases of Necrotizing Enterocolitis |
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Ok Young Kim1, Eun Ju Jeong1, Min Jeong Kim1, Mi Yeon Park2, Son Sang Seo1 |
1Department of Pediatrics, Ilsin Christain Hospital, Pusan, Korea
2Department of Pediatrics, Back Chun Hospital, Ulsan, Korea |
| 신생아 괴사성 장염의 임상적 고찰 |
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김옥영1, 정은주1, 김민정1, 박미연2, 서손상1 |
1일신기독병원 소아과
2백천병원 소아과 |
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| Abstract |
Purpose
: We observed risk factors, clinical findings, diagnosis and treatment of NEC in 23 cases in order to try to prevent developement of, and improve the prognosis of necrotizing enterocolitis(NEC) in the future.
Methods
: 23 cases of NEC who were admitted to the NICU of Ilsin Christian Hospital between Jan 1992 and June 1994 were studied. Data about birth weight, gestational age, risk factors, clinial findings, laboratory findings, radiologic findings, treatment and outcome were collected by review of medical records.
Results
: 1) Among the 23 cases of NEC, low birth weight was 21 cases(91.2%), and prematurity was 20 cases(87%).
2) Clinically, abdominal distension was appeared in all cases. The next most frequently observed clinical finding was lethargy, then metabolic acidosis and then temperature instability.
3) On the plain abdominal X~rays of these cases, pneumatosis intestinalis was found in 15 cases(65.2%), followed by paralytic ileus, free air in the abdomen, portal vein gas, ascites and howel wall edema in order.
4) On blood culture, microorganisms were grown in 5 cases (21.7%). These were Gram positive bacteria in 4 cases and anaerobe in 1 case.
5) According to Modified Bell's staging criteria, suspected NEC was 5 cases(21.7%), definite NEC was 10 cases(43.5%) and advanced NEC was 8 cases(34.8%). ON blood culture, positive result was 1 case(10%) in definite NEC and 4 cases(50%) in advanced NEC. In advanced NEC, the mortality was 100%.
6) The overall mortality rate was 52.2% and the mortality rate among the 21 cases who were treated medically was 47.6% (10/21). The mortality rate among the 2 cases who were recieved an operation was 100% (2/2).
7) The causes of death were intestinal perforation associated with adhesions, pulmonary hemorrhage, prefliaturity and IRDS.
Conclusion
: As the diagnosis of NEC is very difficult and the mortality is high, newborn infants, particularly those who are born prematurely or who have some of the associaed risk factors, must be closely observed in order to prevent its developement. |
| Key Words:
NEC-Necrotizing enterocolitis |
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