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• W4312363213 abstract "There are probably many predisposing and contributing factors in the pathogenesis of NEC. The infant who is at highest risk to develop the condition is premature, low in birth weight or gestational age, has been fed a commercial formula and has had some perinatal stress. Injury to the intestinal mucosa seems to be the primary event, and may be sustained indirectly (most typically) or directly. Ischemic hypoxia is probably most often responsible for this injury, and is presumed secondary to reflex shunting of blood away from the splanchnic bed secondary to asphyxia. Infection is probably secondary in most cases, but can further compromise damaged bowel, contributing to extensive necrosis, perforation, peritonitis, and sepsis in an immunologically immature host. The day of onset is most likely to be in the first 2 weeks of life, and the signs associated with its onset are likely to be subtle and nonspecific or unmistakable and fulminating. The most common reliable diagnostic roentgenologic signs are PI, HPVG and pneumoperitoneum. The overall mortality with confirmed NEC is significant, i.e., 46% in this series. An infant in whom medical management fails and who requires surgery has an understandably higher mortality. Nearly half of those infants who require surgery for necrotic bowel can be saved with limited resection. Ironically, the smallest infants who have the highest mortality are also the most likely to develop NEC. HPVG may be associated with higher mortality. Medical management initiated immediately with any suspicion of the diagnosis in infants who are at high risk to develop the condition is the standard of care. But certainly a means of prevention or earlier diagnosis would be most appropriate in alleviating this scourge of the neonate." @default.
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• W4312363213 date "1980-01-01" @default.
• W4312363213 modified "2023-09-24" @default.
• W4312363213 title "Neonatal Necrotizing Enterocolitis: 100 New Cases" @default.
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• W4312363213 doi "https://doi.org/10.1016/s0065-3101(22)00661-2" @default.
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