TROPICAL ENTEROCOLITIS IN CHILDREN

Besides classical necrotizing enterocolitis (in neonates), which is se en in India as elsewhere in the world, we observe sporadic cases of tr opical enterocolitis, i.e. segmental jejunitis, ileitis or colitis and rarely duodenitis. This is a distinct clinico-pathological entity pre senting as ''acute abdomen'', with pain, bilious vomiting, constipatio n or bloody diarrhoea. The clinical course is not as fulminating as ne onatal necrotizing enterocolitis. Most cases are salvaged by conservat ive treatment especially after the confidence brought by laparoscopic vision of the abdomen, thus excluding perforation or gangrene of the b owel involved. Without laparoscopy, most of the cases end up in laparo tomy. The pathology appears to be a kind of local hyperimmune reaction in the segment of bowel involved, ranging from punctate haemorrhages in the seromuscular layer of the bowel to a generalized red fiery look or perforation due to mucosal ulceration. Whatever the causative agen t, the pathogenesis is of local vasculitis leading to ischemia and var ious patterns of disease.