Necrotizing Enterocolitis in Premature Infants

Neonatal necrotising enterocolitis.

“…Because of this aggressive approach to the disease it is possible that we have been seeing the disease process in some of its developmental stages. NNE may affect any part of the small or large bowel, and, in contrast to other reports (Hopkins et al, 1970;Stevenson et al, 1971;Dudgeon et al, 1973;Santulli et al, 1975) where, in most cases, the small intestine was also involved, in our cases the disease process stopped at the ileocaecal valve.…”

“…The significance of pathogenic bacteria in NNE is difficult to ascertain (Hopkins et al, 1970 thought that the ischaemia of the bowel is followed by bacterial invasion, proliferation, and gas production in the bowel wall (Lancet, 1977). Analysis of the gas in the cyst-like spaces has showed it to be composed largely of hydrogen and to be of microbial origin (Engel, 1975).…”

Rectosigmoidoscopic Findings During Isolated Rectal Bleeding in the Neonate

“…Our interpretation of these data is that the mucosal aspect described in the first child probably indicates NEC, while the second one probably does not. Briefly, despite the presence of risk factors (3)(4)(5)(6)(7)(8)(9) for NEC in 82% children of this series, from an endoscopic point of view the colonic mucosal lesions reported in this study do not seem to proceed from NEC. This assumption is strongly supported by clinical data, as none of these infants exhibited any complication despite early refeeding, nor was there any interruption of feeding in more than half the cases.…”

Digestive Endoscopy in Neonates

“…One child had a mucosa lined by a bloody jelly and covered by ulcerations, and the other exhibited only congestion, edema and petechiae, which might be interpreted as the first child probably having NEC and the second one probably not. In our experience (72), despite the presence of risk factors (92)(93)(94)(95)(96)(97)(98) for NEC in 82% of children, the colonic mucosal lesions did not seem to proceed from NEC, as none of these infants exhibited any complication despite early refeeding, nor was there any interruption of feeding in more than half of the cases. This does not rule out the possibility of mild forms of NEC (99), especially in low birth weight infants.…”