Although necrotizing enterocolitis (NEC) is a primary disease of prematurity, full-term infants a... more Although necrotizing enterocolitis (NEC) is a primary disease of prematurity, full-term infants account for approximately 10% of cases. We retrospectively reviewed the medical records of infants with perforated NEC at two tertiary medical centers over the past fifteen years. Nine full-term and 29 pre-term infants with perforated NEC were enrolled in our study. Among the full-term cases, 4 were older than one month. Perforated NEC was male predominant in pre-term cases and female predominant in full-term cases. Abdominal distention, abdominal wall discoloration and muscle guarding were the most common manifestations in preterm cases, and abdominal distension and bloody stool were most common in full-term cases. The most common abnormal laboratory findings were anemia and metabolic acidosis in preterm cases, and leucocytosis and metabolic acidosis in full-term cases. In pre-term infants, the most common related factors were prenatal problems and maternal disease (19/29, 65.5%), patent ductus arteriosus with indomethacin use (14/29, 48.3%), and sepsis (11/29, 37.9%). In full-term cases, congenital anomaly (5/9, 55.6%) and sepsis (3/9, 33.3%) were the most common related factors, especially in full-term infants older than 1 month. The most common pathogen cultured from patients' blood or ascites was Klebsiella pneumoniae, followed by E. coli, in both pre-term and full-term infants. In conclusion, perforated NEC should be considered in both preterm and full-term babies if infants present with signs of surgical abdomen. To reduce NEC mortality and morbidity in both preterm and full-term infants, early diagnosis and treatment are vitally important, especially in cases with predisposing factors. (Clinical Neonatology 2007;14:75-80)
Although necrotizing enterocolitis (NEC) is a primary disease of prematurity, full-term infants a... more Although necrotizing enterocolitis (NEC) is a primary disease of prematurity, full-term infants account for approximately 10% of cases. We retrospectively reviewed the medical records of infants with perforated NEC at two tertiary medical centers over the past fifteen years. Nine full-term and 29 pre-term infants with perforated NEC were enrolled in our study. Among the full-term cases, 4 were older than one month. Perforated NEC was male predominant in pre-term cases and female predominant in full-term cases. Abdominal distention, abdominal wall discoloration and muscle guarding were the most common manifestations in preterm cases, and abdominal distension and bloody stool were most common in full-term cases. The most common abnormal laboratory findings were anemia and metabolic acidosis in preterm cases, and leucocytosis and metabolic acidosis in full-term cases. In pre-term infants, the most common related factors were prenatal problems and maternal disease (19/29, 65.5%), patent ductus arteriosus with indomethacin use (14/29, 48.3%), and sepsis (11/29, 37.9%). In full-term cases, congenital anomaly (5/9, 55.6%) and sepsis (3/9, 33.3%) were the most common related factors, especially in full-term infants older than 1 month. The most common pathogen cultured from patients' blood or ascites was Klebsiella pneumoniae, followed by E. coli, in both pre-term and full-term infants. In conclusion, perforated NEC should be considered in both preterm and full-term babies if infants present with signs of surgical abdomen. To reduce NEC mortality and morbidity in both preterm and full-term infants, early diagnosis and treatment are vitally important, especially in cases with predisposing factors. (Clinical Neonatology 2007;14:75-80)
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