Document Detail

Indications for operation in acute necrotizing enterocolitis of the neonate.
MedLine Citation:
PMID:  6966078     Owner:  NLM     Status:  MEDLINE    
A study to evaluate criteria for operation was carried out in 61 infants with acute necrotizing enterocolitis (NEC). A total of 10 clinical, roentgenographic, and laboratory criteria were considered. Each proposed operative criterion was correlated with the documented presence or absence of intestinal gangrene in these infants. Indications for operation verified by this study were (1) pneumoperitoneum, (2) paracentesis findings positive for gangrenous intestine, (3) erythema of the abdominal wall, (4) a fixed abdominal mass, and (5) a persistently dilated loop of intestine on serial abdominal radiographs. The first two signs occurred frequently; the latter three were rare. Operative indications which proved to be invalid in this study were (1) clinical deterioration, (2) persistent abdominal tenderness, (3) profuse lower gastrointestinal hemorrhage, (4) the roentgenographic finding of gasless abdomen with ascites, and (5) severe thrombocytopenia. Twenty-four of the infants were operated on. The mortality rate among the infants operated on after free intestinal perforation had occurred (64%) was double that of infants operated on for intestinal gangrene without perforation (30%). Paracentesis may identify infants with intestinal gangrene prior to the development of perforation and may permit advantagenous timing of operation. This analysis of the frequency and reliability of proposed operative criteria may aid the surgical decision.
A M Kosloske; L A Papile; J Burstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  87     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1980 May 
Date Detail:
Created Date:  1980-06-27     Completed Date:  1980-06-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  502-8     Citation Subset:  AIM; IM    
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MeSH Terms
Ascites / etiology
Enterocolitis, Pseudomembranous / complications,  surgery*
Erythema / etiology
Gangrene / etiology
Gastrointestinal Hemorrhage / etiology
Infant, Newborn
Infant, Newborn, Diseases / complications,  surgery*
Pneumoperitoneum / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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