Enterocolitis, necrotizing

This is a potentially fatal condition of the newborn associated with prematurity and thought to be related to decreased perfusion of the intestine (Kleinhaus et al., 

Although there is no data relating to free-radical activity in humans, several animal models have been developed (Parks etal., 1983). Pitt etal. (1991) showed that more severe injury occurred in the proximal small intestine, where levels of XO were highest. SOD has been reported to be protective in a rat model (Dalsing et al., 1983) and more recently a tungsten-supplemented diet was also found to be of benefit (Pitt et al., 1991). However, whether such treatment could modify the human disease, which usually develops within 10 days of birth, remains to be seen. 

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Kleinhaus, S., Weinberg, G. and Gregor, M.B. (1992). Necrotizing enterocolitis in infancy. Surg. Clin. North Am. 72, 261-276. 

Short-gut syndrome (e.g., intestinal artresia, necrotizing enterocolitis, intestinal volvulus, massive resection secondary to inflammatory bowel disease, tumors, mesenteric thrombosis)... 

Birth asphyxia Hypothermia Meconium or amniotic fluid aspiration Necrotizing enterocolitis Respiratory distress syndrome Shock Obstetrics Abortion... 

Severe hemorrhagic pancreatitis Severe necrotizing pancreatitis Necrotizing enterocolitis Diffuse peritonitis Small bowel obstruction Paralytic ileus... 

The only absolute contraindications are mechanical obstruction and necrotizing enterocolitis. Conditions that challenge the success of EN include severe diarrhea, protracted vomiting, enteric fistulae, severe GI hemorrhage, and intestinal dysmotility. 

To define the incidence of fractures and rickets that we were encountering in infants who required prolonged parenteral feeding, we reviewed the roentgenograms of a series of preterm infants who developed necrotizing enterocolitis and who required at least four weeks of total parenteral nutritional support (4). These data are recorded in Table I. 

Small birth weight and necrotizing enterocolitis of a fetus resulted from the mother s use of a corticosteroid. 

Contraindications Bone marrow aplasia, historyofgold-induced pathologies (including blood dyscrasias, exfoliative dermatitis, necrotizing enterocolitis, and pulmonary fibrosis), severe blood dyscrasias... 

Octreotide has been used in premature neonates for closure of enterocutaneous fistulae complicating necrotizing enterocolitis. Two cases of oxygen desaturation have been reported (12). The authors suggested that the effect may relate to pre-existing hyaline membrane disease. 

Furukawa, M., Narahara, H., Lee, E.L., Johnston, J.M. 1994. Platelet-activating factor acet-ylhydrolase activity in human milk and its possible role in the prevention of necrotizing enterocolitis. J. Lipid Medial. Cell Signal. 10, 93-94. 

Cocaine exposure in utero can affect various fetal organs. Gastrointestinal disorders, including ten cases of necrotizing enterocolitis (291), one of intestinal atresia, and one of spontaneous colonic perforation, have been reported (292). 

Downing GJ, Horner SR, Kilbride HW. Characteristics of perinatal cocaine-exposed infants with necrotizing enterocolitis. Am J Dis Child 1991 145(l) 26-7. 

Gastrointestinal Constipation, diarrhea, necrotizing enterocolitis in fetus or newborn, increased liver enzymes... 

A premature small-for-dates girl (34 weeks gestation, birth weight 1000 g) received parenteral nutrition for necrotizing enterocolitis. On day 7, among several septic spots that developed on the skin, an abscess... 

Two patients developed necrotizing enterocolitis after a first cycle of chemotherapy for epithelial ovarian/perito-neal cancer both were due to vasculitis (19). 

The possible association of indometacin tocolysis with neonatal necrotizing enterocolitis has been the subject of a case-control study (53). All cases of proven necrotizing enterocolitis were ascertained and four controls for each case were randomly identified. During 18 months there were 24 cases of necrotizing enterocolitis. Indometacin as a single tocolytic agent was not associated with necrotizing enterocolitis (OR = 1.0, 95% Cl = 0.2, 4.8). 

ParUla BV, Grobman WA, Holtzman RB, Thomas HA, Dooley SL. Indomethacin tocolysis and risk of necrotizing enterocolitis. Obstet Gynecol 2000 96(l) 120-3. 

Gram-negative septicemia possibly related to oral Gastrografin has also been reported in a premature neonate with necrotizing enterocolitis (48). 

Some cases of necrotizing enterocolitis have been reported in infants with paralytic ileus after treatment for mild diarrhea (3). This is only one of the good reasons to avoid the drug in young children the most important is that diarrhea in infants should not be suppressed pharmacologically (4). 

Premature neonates are reported to have a relative deficiency of vitamin E at birth, which has been associated with hemolytic anemia (16). Since there was an increased incidence of necrotizing enterocolitis when oral tocopherol was given to such infants (7,8,17,18), parenteral tocopherol was for a while recommended for use in very ill neonates (19,20). 

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