Necrotizing enterocolitis: Experience of 27 cases from a single Korean institution

Necrotizing enterocolitis (NEC) can involve any site in the gastrointestina l tract and is a fatal complication of immunosuppression. To characterize N EC, clinical and radiological characteristics were analyzed. A total of 27 cases of NEC were identified from January 1993 to August 1998, and medical records were reviewed. NEC was diagnosed by clinical and radiological crite ria, and other mimicking conditions were excluded. Of the NEC cases, 22 (81 .5%) occurred in patients with underlying hematologic malignancy. All patie nts complained of abdominal pain and fever at the time of inclusion. Escher ichia coli was the most common pathogen identified. The most common finding by computed tomography was single-layered diffuse bowel wall thickening wi th variable density. Other findings were ascites, fascial thickening, pneum atosis, and mesenteric lymphadenopathy. Of the patients, 25 were treated wi th antimicrobials with or without recombinant hematopoietic growth factors, and 2 were treated with surgery because of perforation and profound bleedi ng. Among the 12 patients who died, NEC was the direct cause of death in 7 patients. In conclusion, computed tomography is an effective tool for early diagnosis of NEC. Bowel rest, broad-spectrum antimicrobials, and recombina nt hematopoietic growth factors are important aspects of treatment. Surgery should be reserved for complicated cases. Int J Hematol. 2000;72:358-361. (C) 2000 The Japanese Society of Hematology.