Research Information System
Pediatrik Cerrahi Dergisi, vol.15, no.1, pp.20-27, 2001 (Scopus)
Background/Purpose: Necrotising enterocolitis (NEC) remains a major life threatening disease seen in neonatal intensive care units (NICU). NEC is a multifactorial disease, although bowel ischemia and necrosis play a significant role in its pathogenesis. Method: This retrospective study was performed to evaluate the demographic, clinical and radiological findings of 62 cases with NEC who were diagnosed and followed in our NICU. Results: The incidence of NEC was 6.1 per 100 special care nursery admission in our NICU. The mean gestational age was 32.9±4.3 (24-40) weeks, and mean birth weight was 1687±795 (600-4250) grams. The mean age at diagnosis was 8.9±9.0 (2-52) days. Before onset of NEC, 77% of the cases were fed enterally. Major risk factors for NEC were prematurity, perinatal asphyxia, oxygen therapy, sepsis, acidosis, umbilical catheterization, anemia, polycythemia, hypoalbuminemia, cold injury, RDS and formula feeding. Predominant clinical findings were hypoactivity, gastric residuals, abdominal distention, hypoperfusion, apnea, hypothermia and abdominal mass. The rates of thrombocytopenia and acute phase reactant (APR) positivity were 42% and 39%, respectively. Positive blood cultures were present in 39% of cases. Radiological findings were thickening of bowel wall (95%), persisted and dilated loops of bowel (39%), pneumatosis intestinalis (39%) and pneumoperitoneum (3%). Intravenous immunoglobulin (IVIG), IgM enriched IVIG and/or G-CSF were given in 86% of cases as supportive therapy. The frequencies of NEC-stage I, II and III were 45%, 48% and 7%, respectively, NEC associated mortality rate was 16%. Conclusion: We think that APRs are useful for early diagnosis of NEC, and supportive therapies may reduce the mortality rate of of this disease.