• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of annsurgLink to Publisher's site
Ann Surg. Jan 1978; 187(1): 1–7.
PMCID: PMC1396409

Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging.

Abstract

A method of clinical staging for infants with necrotizing enterocolitis (NEC) is proposed. On the basis of assigned stage at the time of diagnosis, 48 infants were treated with graded intervention. For Stage I infants, vigorous diagnostic and supportive measures are appropriate. Stage II infants are treated medically, including parenteral and gavage aminoglycoside antibiotic, and Stage III patients require operation. All Stage I patients survived, and 32 of 38 Stage II and III patients (85%) survived the acute episode of NEC. Bacteriologic evaluation of the gastrointestinal microflora in these neonates has revealed a wide range of enteric organisms including anaerobes. Enteric organisms were cultured from the blood of four infants dying of NEC. Sequential cultures of enteric organisms reveal an alteration of flora during gavage antibiotic therapy. These studies support the use of combination antimicrobial therapy in the treatment of infants with NEC.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Barlow B, Santulli TV. Importance of multiple episodes of hypoxia or cold stress on the development of enterocolitis in an animal model. Surgery. 1975 May;77(5):687–690. [PubMed]
  • Barlow B, Santulli TV, Heird WC, Pitt J, Blanc WA, Schullinger JN. An experimental study of acute neonatal enterocolitis--the importance of breast milk. J Pediatr Surg. 1974 Oct;9(5):587–595. [PubMed]
  • Bell MJ, Kosloske AM, Benton C, Martin LW. Neonatal necrotizing enterocolitis: prevention of perforation. J Pediatr Surg. 1973 Oct;8(5):601–605. [PubMed]
  • Book LS, Herbst JJ, Atherton SO, Jung AL. Necrotizing enterocolitis in low-birth-weight infants fed an elemental formula. J Pediatr. 1975 Oct;87(4):602–605. [PubMed]
  • Dudgeon DL, Coran AG, Lauppe FA, Hodgman JE, Rosenkrantz JG. Surgical management of acute necrotizing enterocolitis in infancy. J Pediatr Surg. 1973 Oct;8(5):607–614. [PubMed]
  • Egan EA, Mantilla G, Nelson RM, Eitzman DV. A prospective controlled trial of oral kanamycin in the prevention of neonatal necrotizing enterocolitis. J Pediatr. 1976 Sep;89(3):467–470. [PubMed]
  • Frantz ID, 3rd, L'heureux P, Engel RR, Hunt CE. Necrotizing enterocolitis. J Pediatr. 1975 Feb;86(2):259–263. [PubMed]
  • Hill HR, Hunt CE, Matsen JM. Nosocomial colonization with Klebsiella, type 26, in a neonatal intensive-care unit associated with an outbreak of sepsis, meningitis, and necrotizing enterocolitis. J Pediatr. 1974 Sep;85(3):415–419. [PubMed]
  • Hillman LS, Goodwin SL, Sherman WR. Identification and measurement of plasticizer in neonatal tissues after umbilical catheters and blood products. N Engl J Med. 1975 Feb 20;292(8):381–386. [PubMed]
  • Leonidas JC, Hall RT. Neonatal pneumatosis coli: a mild form of neonatal necrotizing enterocolitis. J Pediatr. 1976 Sep;89(3):456–459. [PubMed]
  • Lloyd JR. The etiology of gastrointestinal perforations in the newborn. J Pediatr Surg. 1969 Feb;4(1):77–84. [PubMed]
  • Richmond JA, Mikity V. Benign form of necrotizing enterocolitis. Am J Roentgenol Radium Ther Nucl Med. 1975 Feb;123(2):301–306. [PubMed]
  • Roback SA, Foker J, Frantz IF, Hunt CE, Engel RR, Leonard AS. Necrotizing enterocolitis. An emerging entity in the regional infant intensive care facility. Arch Surg. 1974 Aug;109(2):314–319. [PubMed]
  • Sántulli TV, Schullinger JN, Heird WC, Gongaware RD, Wigger J, Barlow B, Blanc WA, Berdon WE. Acute necrotizing enterocolitis in infancy: a review of 64 cases. Pediatrics. 1975 Mar;55(3):376–387. [PubMed]
  • Smith DH, Van Otto B, Smith AL. A rapid chemical assay for gentamicin. N Engl J Med. 1972 Mar 16;286(11):583–586. [PubMed]
  • Speer ME, Taber LH, Yow MD, Rudolph AJ, Urteaga J, Waller S. Fulminant neonatal sepsis and necrotizing enterocolitis associated with a "nonenteropathogenic" strain of Escherichia coli. J Pediatr. 1976 Jul;89(1):91–95. [PubMed]
  • Stevenson JK, Graham CB, Oliver TK, Jr, Goldenberg VE. Neonatal necrotizing enterocolitis. A report of twenty-one cases with fourteen survivors. Am J Surg. 1969 Aug;118(2):260–272. [PubMed]
  • Stevenson JK, Oliver TK, Jr, Graham CB, Bell RS, Gould VE. Aggressive treatment of neonatal necrotizing enterocolitis: 38 patients with 25 survivors. J Pediatr Surg. 1971 Feb;6(1):28–35. [PubMed]
  • Torma MJ, DeLemos RA, Rogers JR, Jr, Diserens HW. Necrotizing enterocolitis in infants. Analysis of forty-five consecutive cases. Am J Surg. 1973 Dec;126(6):758–761. [PubMed]
  • Touloukian RJ, Kadar A, Spencer RP. The gastrointestinal complications of neonatal umbilical venous exchange transfusion: a clinical and experimental study. Pediatrics. 1973 Jan;51(1):36–43. [PubMed]
  • Touloukian RJ, Posch JN, Spencer R. The pathogenesis of ischemic gastroenterocolitis of the neonate: selective gut mucosal ischemia in asphyxiated neonatal piglets. J Pediatr Surg. 1972 Apr;7(2):194–205. [PubMed]
  • Weinstein WM, Onderdonk AB, Bartlett JG, Louie TJ, Gorbach SL. Antimicrobial therapy of experimental intraabdominal sepsis. J Infect Dis. 1975 Sep;132(3):282–286. [PubMed]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...