All issues > Volume 38(7); 1995

Original Article

J Korean Pediatr Soc. 1995;38(7):886-894. Published online July 15, 1995.

A Clinical Observation of 23 Cases of Necrotizing Enterocolitis

Ok Young OY Kim¹, Eun Ju EJ Jeong¹, Min Jeong MJ Kim¹, Mi Yeon MY Park², Son Sang SS Seo¹

¹Department of Pediatrics, Ilsin Christain Hospital, Pusan, Korea
²Department of Pediatrics, Back Chun Hospital, Ulsan, Korea

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.

Keywords :NEC-Necrotizing enterocolitis