We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Post-necrotizing Enterocolitis Stricture: Misdiagnosis of this Complication Results in Greater Infant Mortality.
- Authors
İnce, Emine; Ezer, Semire Serin; Temiz, Abdülkerim; Gezer, Hasan Özkan; Hiçsönmez, Akgün
- Abstract
Objective: Intestinal stricture following necrotizing enterocolitis (NEC) is often misdiagnosed as recurrent functional constipation, enteritis, and malnutrition, and it increases the rates of morbidity and mortality in infants. Although a number of studies have focused on the potential etiologic factors leading to NEC, the information regarding the occurrence and diagnosis of post-NEC strictures is limited. The aim of this study was to evaluate the clinical presentation and diagnostic and surgical methods to treat NEC. Materials and Methods: The medical records of infants who had undergone surgery for post-NEC strictures between January 2005 and September 2018 were evaluated retrospectively in a single institution. Results: This study included 38 infants (20 males, 18 females) with post-NEC stricture. Their histories revealed that they had been treated medically (20 of 38) or surgically (18 of 38) for NEC. Symptoms typical of intestinal obstruction (vomiting, abdominal distension, constipation, growth retardation, etc.) were present in the medically treated patients. The average time of onset of symptoms after the acute episode of NEC was 1.64±0.78 months. Contrast studies revealed strictures in the small intestine in 13 (65%) medically treated patients, while 13 (72.2%) surgically treated patients had strictures in the colon. Additionally, 2 of surgically treated patients presented with ileocolic fistulae. In 11 of 38 (28.9%) patients, the contrast studies were false-negative. Conclusion: Post-NEC strictures may present with vague nutritional problems, causing the diagnosis to often be missed, which leads to high rates of morbidity and mortality in infants. Colon enemas, distal loopograms, and small bowel passage radiograms are useful in making a diagnosis, but a careful examination of the intestines for the presence of any other strictures should be done during the surgery.
- Subjects
ENTEROCOLITIS; NATIONAL Exhibition Centre Ltd.; INFANT mortality; BOWEL obstructions; DIAGNOSTIC errors; SMALL intestine; COLON (Anatomy); ENEMA; URETHROPLASTY
- Publication
Erciyes Medical Journal / Erciyes Tip Dergisi, 2019, Vol 41, Issue 4, p394
- ISSN
2149-2247
- Publication type
Article
- DOI
10.14744/etd.2019.98470