All issues > Volume 28(5); 1985

Original Article

J Korean Pediatr Soc. 1985;28(5):423-434. Published online May 31, 1985.

clinical Observation on Neonatal Necrotizing Enterocolitis(Nec).

Jung Hwan Choi, Chong Ku Yun

¹Department of Pediatrics,College of Medicine, Seoul National University

Abstract

A clinnical observation was done on 9 cases of NEC who were admitted to the NICU and Pediatric and Pediatric Surgery Ward, Seoul National University Hospital during the period of 5 years from January 1979 to December, 1984. The results were as follows: 1)Among 9 cases of NEC, LBWI below 2,500 g were 3 cases(33.3%) and premature babies below 38 weeks of gestational age were 4 cases(44.4%). 2)There was no difference in sex ratio. 3) The onset of 5 cases(55.5%) of NEC appeared within 7 days of life, 2 cases in 7~28 days of life and 2 cases in 28~42 days of life. 4)Risk factors during pregnancy and delivery which could cause the 9 cases of NEC were C-Section, premature rupture of membrane, breech delivery, difficult delivery, preeclampsia, eclampsia, SLE, meconium staining, in order. 3 cases had not any risk factor. 5) Neonatal complication in 9 cases of NEC were sepsis, low Apgar score, RDS, pneumonia, UTI, asphyxia, DIC, and CMC, in order. 2 cases had not any neonatal complication. 6) As clinical presentations, abdominal distension was appeared in 9 cases(100%), and lethargy, vomiting (blood or bile), diarrhea, gastric retention of formula, temperature instability, and etc, in order. 7)On simple abdomen X-ray, they showed the abnormal findings with the loss of bowel interface and segments or elongated, “sausage shaped” bowel loops in 9 cases(100%)/pneumatosis intestinalis in 5 cases(55.5%), hepatic portal venous gas in 3 cases(33.3%) and pneumoperitoneum in 3 cases (33.3%). 8)On blood culture, micro-organisms were grown in 5 cases(55.5%), which were Klebsiella pneumoniae in 2 cases, E. coli, Enterobacter aerogenes, Salmonella enteritidis and Staphylococcus aureus in each one case. 9)The pathological findings of 3 cases who received operation were serosanguineous ascites, dialted proximal bowels, single, slit or multiple perforations, intramural air trappings, gangrenous necrosis, patch necrosis with pneumatosis, multiple microabscess on the bowel wall and adhesions of bowels. 10)In an autopsy case, there were dilated proximal bowel, multiple perforations, gangrenous necrosis, intramural gas in the bowels and lateral sinus thrombosis and hemorrhagic necrosis of left thalamus in the brain. 11)Overall mortality rate was 33.3% and morality rate among 3 cases who received operation was 66.7%(2/3) and mortality rate among 6 cases who were treated medically was 16.7% (1/6).

Keywords :Neonatal necrotizing enterocolitis (NEC)