Neonatal necrotizing enterocolitis

Stevenson, John K.; Graham, C. Benjamin; Oliver, Thomas K.; Goldenberg, Victor E.

doi:10.1016/0002-9610(69)90129-9

Cited by 83 publications

(7 citation statements)

References 20 publications

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“…Virtually all previous reports of this syndrome (Sealy, 1953;Lober and Lillehei, 1954;Ring and Lewis, 1950) have demonstrated a marked predilection for bowel ischemia to occur in the terminal ileum and cecum. Furthermore, clinical experience with a newborn form of ischemic bowel disease has also noted a strong tendency for the terminal ileum and cecum to suffer ischemic damage (Touloukian et al, 1967;Stevenson et al, 1969;Briski et al, 1982). Is there is a discernible physiological basis for this known predisposition of the terminal ileum to suffer ischemic damage?…”

Section: Discussionmentioning

confidence: 99%

“…The predilection of the gut on either side of the ileocecal value to suffer ischemic damage is well known to the surgeon, neonatologist, and cardiologist (Sealy, 1953;Lober and Lillehei, 1954;Ring and Lewis, 1956;Touloukian et al, 1967;Stevenson et al, 1969;Briski et al, 1982). To date, there have been no studies directed at identifying the cause of this peculiar distribution of ischemic lesions, although ill-defined anatomic considerations have been invoked in the past (Ring and Lewis, 1956).…”

Section: Regulation Of Terminal Deal and Cecal Blood Flowmentioning

confidence: 99%

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Resting and exercise renal blood flows in immature ovine aortic coarctation. Impact of gradient relief.

Lock

Kulik

Green

et al. 1983

Circulation Research

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SUMMARY. The primary purpose of this study was to determine whether a neonatally induced thoracic aortic coarctation reduces renal blood flow dunng physiological stress (treadmill exercise), and whether relief of the gradient returned renal blood flow during exercise to normal. Two ancillary questions were also addressed: does a coarctahon alter the responses of enteric and other visceral vascular beds to treadmill exercise? Eight newborn lambs that underwent sham thoracotomy with placement of left atrial lines served as controls; in seven Iambs we also created a recently described form of dilatable juxtaductal coarctation. This preparation is unique in that, like human coarctation, the obstruction does not get worse as the animal grows. Rest and exercise vascular pressures and regional blood flows were detemined 2-2V2 months after surgery. Coarctations were relieved with balloon dilation angioplasty catheters, inserted percutaneously. Postdilation rest and exercise hemodynamic studies were performed, at the same level of exercise, 24 hours after dilation. Renal blood flow did not change with exercise in the control animals. In lambs with coarctation, renal blood flow fell (-22%, P < 0.01) during exercise. Unexpectedly, an exercise-induced fall in renal blood flow (-22%, P < 0.001) persisted even after effective relief of the coarctation (descending aortic blood pressure fell 25% with exercise predilarion, but remained unchanged with exercise postdilation). Blood flow to the terminal ileum and cecum followed a qualitatively similar pattern to that of renal blood flow in control, predilation, and postdilation lambs, and this pattern was distinct from that of other enteric and visceral organ flows. These results demonstrate an expected abnormality in the regulation of exercise renal blood flow in lambs with coarctation of the aorta; however, the persistence of this abnormality after effective gradient relief does not support the previously advanced theory that postcoarctarion hypertension is largely nonrenal in origin. The apparent similarity between ileocecal and renal blood flow control under these circumstances may provide a clue to the known predilection of the terminal ileum to suffer ischemic injury. (Circ Res 53: 644-654, 1983) EARLIER in this century, the hyptertension above an aortic coarctation was attributed to abnormal aortic wall compliances (Blumgart et al., 1931;Bing et al., 1948). Subsequently, however, renal autotransplantation experiments indicated an important role of the kidney in producing this hypertension (Scott and Bahnson, 1951), presumably on the basis of impaired renal blood flow (RBF) (Parker et al., 1982). Despite this, previous attempts to document a coarctation-associated decrease in renal perfusion have either been unsuccessful (Harris et al., 1950;Fallo et al., 1978), or have required the unphysiological stresses of marked sodium restriction and/or general anesthesia (Bagby et al., 1975;Alpert et al., 1979). Thus, the mechanism by which a coarctation produces hypertension remai...

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Section: Discussionmentioning

confidence: 99%

Section: Regulation Of Terminal Deal and Cecal Blood Flowmentioning

confidence: 99%

Resting and exercise renal blood flows in immature ovine aortic coarctation. Impact of gradient relief.

Lock

Kulik

Green

et al. 1983

Circulation Research

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“…Postmortem examination revealed inflammation and one or multiple perforation(s) of the colon, that is, the typical pathological findings in necrotising enterocolitis 1. In the following decades only scattered reports of such cases appeared, until the term ‘necrotising enterocolitis’ (NEC) was introduced for this disease entity in the 1950s, and larger case series were reported thereafter 2 3. Despite important advances in neonatology, NEC still remains a devastating disorder affecting up to 10% of infants with a gestational age <28 weeks.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of abdominal ultrasound in diagnosing necrotising enterocolitis

Bohnhorst

2013

Arch Dis Child Fetal Neonatal Ed

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Necrotising enterocolitis is a serious disorder in preterm infants with a mortality of up to 60%. Therefore, early and precise diagnosis and rapid initiation of proper treatment are essential. Clinically suspected diagnosis is usually confirmed by typical findings on plain abdominal radiograph, for example, pneumatosis intestinalis, portal venous gas and, in case of intestinal perforation, pneumoperitoneum. Recently, there has been growing evidence that with real-time ultrasound, intramural air and portal gas can be better detected than with x-ray. Furthermore, ultrasound is able to assess the bowel wall directly and detect bowel wall thickening or thinning, reduced peristalsis or disturbed bowel wall perfusion. Intra-abdominal fluid, both intraluminal or extraluminal is also visible. However, data regarding the diagnostic validity and prognostic value of abdominal ultrasound are limited and often focused on a single finding rather than a combination of them. Additionally, until now, ultrasound findings seem to have little influence on therapeutic decisions. Therefore, the value of abdominal ultrasound in the diagnosis of necrotising enterocolitis has to be determined by further studies until its use can be generally recommended.

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“…It seems to be more common in premature babies (Rossier, et al, 1959;Berdon et al, 1964;Mizrahi et al, 1965) and particularly when they have suffered from asphyxia, apnoeic attacks, hyaline membrane disease, or hypothermia. These stress conditions may give rise to intestinal ischaemia with devitalization, infection, and necrosis (Lloyd, 1969;Stevenson et al, 1969;Fetterman, 1971). Stasis of intestinal contents seems important in some cases.…”

Section: Introductionmentioning

confidence: 99%

Gastroenteritis with Necrotizing Enterocolitis in Premature Babies

Stein¹,

Beck²,

Solomon³

et al. 1972

BMJ

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SummaryEleven premature babies developed necrotizing enterocolitis in an epidemic of gastroenteritis and salmonella infection. This occurred in one of two premature baby wards over a period of 10 weeks. All affected babies had severe gastroenteritis and six had salmonella infection. No cases of necrotizing enterocolitis occurred in the unaffected ward during the same period. All other possible factors which might have predisposed to necrotizing enterocolitis occurred with equal frequency in both wards.There seems little doubt that infection was the significant factor in the pathogenesis.

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Neonatal necrotizing enterocolitis

Cited by 83 publications

References 20 publications

Resting and exercise renal blood flows in immature ovine aortic coarctation. Impact of gradient relief.

Resting and exercise renal blood flows in immature ovine aortic coarctation. Impact of gradient relief.

Usefulness of abdominal ultrasound in diagnosing necrotising enterocolitis

Gastroenteritis with Necrotizing Enterocolitis in Premature Babies

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