Evidence vs experience in the surgical management of necrotizing enterocolitis and focal intestinal perforation

C. J. Hunter, N. Chokshi, H. R. Ford

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

Introduction:Necrotizing enterocolitis (NEC) and focal intestinal perforation (FIP) are neonatal intestinal emergencies that affect premature infants. Although most cases of early NEC can be successfully managed with medical therapy, prompt surgical intervention is often required for advanced or perforated NEC and FIP.Methods:The surgical management and treatment of FIP and NEC are discussed on the basis of literature review and our personal experience.Results:Surgical options are diverse, and include peritoneal drainage, laparotomy with diverting ostomy alone, laparotomy with intestinal resection and primary anastomosis or stoma creation, with or without second-look procedures.Conclusions:The optimal surgical therapy for FIP and NEC begins with prompt diagnosis and adequate fluid resuscitation. It appears that there is no significant difference in patient outcome based on surgical management alone. However, the infant's weight, comorbidities, surgeon preference and timing of intervention should be taken into account before operative intervention.

Original languageEnglish (US)
Pages (from-to)S14-S17
JournalJournal of Perinatology
Volume28
DOIs
StatePublished - May 2008
Externally publishedYes

Keywords

  • Intestinal perforation
  • Necrotizing enterocolitis
  • Surgery

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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