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The frequency of necrotizing enterocolitis (NEC) in the extremely premature infant
(<1,000 g) is still high and it is very difficult for infants weighing <1,000 g with
NEC perforation to survive. In our institutes, the management protocol for NEC perforation
in infants weighing <1,000 g includes peritoneal drainage under local anesthesia,
administration of coagulating factor XIII, and the usual treatment for septic shock.
During the past 3 years, four infants weighing <1,000 g with NEC perforation have
survived using this protocol without laparotomy. This management protocol is the treatment
of choice in infants in very poor condition or infants weighing <1,000 g with NEC
perforation.
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References
- Peritoneal drainage for necrotizing enterocolitis.J Pediatr Surg. 1988; 23: 557-561
- A 13-year experience with peritoneal drainage under local anesthesia for necrotizing enterocolitis perforation.J Pediatr Surg. 1990; 25: 1034-1037
- Resection with primary anastomosis for necrotizing enterocolitis: A contrasting view.J Pediatr Surg. 1988; 23: 64-68
- Primary anastomosis for necrotizing enterocolitis: A 12-year experience.J Pediatr Surg. 1989; 24: 515-518
- Is the frequency of necrotizing enterocolitis decreased? What is the factors?.NICU. 1990; 3 (in Japanese): 613-618
- A multicenter well-controlled study of factor XIII-concentrate (Fibrogammin®) in the treatment of patient with impaired wound healing—Comparison with an untreated control group.Saishin Igaku. 1984; 39 (in Japanese): 2132-2143
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Footnotes
*Presented at the 24th Annual Meeting of the Pacific Association of Pediatric Surgeons, Hong Kong, May 20–24, 1991.
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Copyright
© 1992 W.B. Saunders Company. All right reserved. Published by Elsevier Inc.
