INTERDISCIPLINARY TREATMENT OF NECROTIZING ENTEROCOLITIS AND SPONTANEOUS INTESTINAL PERFORATIONS IN PRETERM INFANTS

From January 1986 to December 1992, 13 patients with necrotizing enter ocolitis (NEC) (Grade II-III; Bell) were treated. The incidence was hi ghest in the very immature infants with birth weight < 1000 g: 6/148 ( 4%). From onset, NEC was associated with clinical symptoms such as abd ominal distension, bloody stools, retained gastric contents and septic emia. Indications of inflammation were seen in only 6 out of 13 patien ts at the time of diagnosis. No complications were seen in 10 patients during the acute phase. Two infants developed a bowel perforation and another one a gangrene. Immediate surgery was performed. In three oth er infants, elective surgery was performed because of colonic strictur es. Twelve (92%) patients survived NEC. Five other VLBW infants develo ped spontaneous perforations of the bowel. The clinical presentation, laboratory and radiological findings differed greatly from those with NEC. Four infants survived. A primarily conservative therapeutic regim e with close cooperation between the surgeon and pediatrician may be a n alternative to early surgical intervention in NEC.