Neonatal necrotizing enterocolitis: a clinical study.
Necrotizing enterocolitis was found in 77 infants over a 5 year period. Diagnosis of NEC was established on 4.9 + 4.8 days in babies with birth weight of 1667 + 577 grams and the gestational age of 33.3 + 2.6 weeks. Definite disease occurred in 33 (42.9%) babies while there was strong suspicion in another 44 (57.1%) babies. Prefeed gastric residue (98.7%), abdominal distension (97.3%), lethargy (78.7%), hypotonia (60%) and jaundice (48%) were the main presenting features. However, blood in stools and abdominal wall erythema were found in 38.7% babies. About one third of infants had a positive blood culture. Pneumatosis intestinalis was present in 83.9% of babies and pneumoperitoneum was seen in 35.5% of neonates with NEC. Ileo-ceco-colic region was the commonest site of involvement. Overall survival was 61% and survival with Stage III was only 13%. Birth weight less than 1500 g, gestational age less than 32 weeks, erythema of the abdominal wall, intra-abdominal mass, portal venous gas in abdominal X-ray and Gram negative septicemia were associated with higher mortality.
Narang
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Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh.
Rao
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Bhakoo
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ON
D017668:Age of Onset; D001724:Birth Weight; D002954:Citrobacter / Q000302:isolation & purification; D004761:Enterocolitis, Pseudomembranous / Q000000981:diagnostic imaging / Q000382:microbiology / Q000401:mortality*; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D007709:Klebsiella / Q000302:isolation & purification; D008297:Male; D010500:Perinatology; D011860:Radiography, Abdominal; D012307:Risk Factors; D012486:Salmonella typhimurium / Q000302:isolation & purification; D012720:Severity of Illness Index; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification; D015996:Survival Rate