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At least 433 records · Page 24Linked to original sources
PubMed1992

[Determination of hydrogen in expiratory air of premature infants in suspected necrotizing enterocolitis].

BACKGROUND: Breath hydrogen (H2) analysis has been recommended for the differential diagnosis between necrotizing enterocolitis and transient feeding intolerance. METHODS: We performed 360 breath H2 analyses in 32 unselected premature babies by use of an electrochemical method. RESULTS: All babies on oral feedings excreted H2. The concentration of H2 in expired air was extremely variable and often high even in well premature babies. Antibiotic medication (other than penicillin G alone) inhibited breath hydrogen excretion. CONCLUSIONS: Breath hydrogen analysis can be used as a diagnostic tool for necrotizing enterocolitis if performed in a symptomatic child on oral feedings prior to the initiation of antibiotic therapy.

Birth Weight↗
PubMed1992

Neutropenic enterocolitis associated with autologous bone marrow transplantation.

Fatal neutropenic enterocolitis was seen in a patient undergoing autologous bone marrow transplantation for non-Hodgkin's lymphoma. Excessive drug action due to a mildly diminished creatinine clearance could have contributed to the pathogenesis. Computed tomographic scanning and ultrasonography demonstrated pneumatosis of the gastrointestinal tract, but the disease had become extensive by then. Necrotizing enterocolitis should be suspected early in a granulocytopenic patient with abdominal pain and diarrhea or vomiting. Aggressive surgical or medical management may avoid a fatal outcome.

Adult↗
PubMedDate not supplied

[Effects of glutamine supplemented parenteral nutrition on the incidence of necrotizing enterocolitis, nosocomial sepsis and length of hospital stay in very low birth weight infants].

INTRODUCTION: Parenteral feeding is the basic way of nutrition in the first day of life in infants with very low birth weight. Due to its instability glutamine is not included in aminoacid solutions used for parenteral nutrition. Meanwhile glutamine is an important aminoacid, which plays a major role in the maturation of the gastrointestinal tract as well as the immunological system. AIM OF THE STUDY: The aim of our study was to estimate if glutamine supplementation of parenteral nutrition in neonates with the very low birth weight can decrease the incidence of necrotizing enterocolitis -- NEC (> 1 degree according to the Bell criteria), nosocomial sepsis, and shorten the total length of hospitalization. MATERIAL AND METHODS: Prospective, randomized study included 55 neonates born between 26 and 32 weeks of gestation, with birth weight range of 580 g to 1250 g. On the third day of life patients were randomized into 2 groups. Each group was fed with a different aminoacid solution. Group 1 consisted of patients who received a standard aminoacid solution with an addition of glutamine dipeptide (20% of total amount of aminoacids). Group 2 (acknowledged as the control group) including 30 patients received a standard aminoacid solution. Glutamine and glutaminic acid levels were checked in the cord blood, and on the 3rd and 14th day of life. Venous samples were taken at 8 a.m. and were estimated using HPLC. The Ethics Committee of the Warsaw Medical University had approved the research. RESULTS: In group 1 nosocomial sepsis had occurred in 7/25 neonates, and in the control group in 11/30; NEC was diagnosed in none of the 25 neonates in group 1 and in 5/30 of the control group; the total length of hospitalization in group 1 was 75 days (median 70) versus 73 in the control group (median 70). The lowest glutamine concentration was noted in cord blood samples, and increased on the third day of life in both groups. There were a statistically significant difference among the levels of glutamine concentration between the cord sample and the sample on the day three (p<0.01). On the 14th day of life glutamine concentration increased in both groups, but it was about 30% higher in group 1. This was statistically significant. CONCLUSIONS: Glutamine supplemented parenteral nutrition from day 4 to day 14 among neonates with very low birth weight, decreased the incidence of necrotizing enterocolitis, but it did not influence the incidence of hospital acquired sepsis, as well as the length of stay in the intensive care unit, and the total time of hospitalization. Further research is needed to estimate the role of glutamine in preventing gastrointestinal complications observed during sepsis.

Cross Infection↗
PubMed1991

[Microbiologic findings in protracted and chronic enterocolitis].

Novel diagnostic methods (immunoblotting, immunofluorescence test) have been proved to be very sensitive and specific for detecting enteropathogenic bacilli. 28 patients with chronic enterocolitis were investigated. In 50% (14/28) of these patients Yersinia enterocolitica could be visualized in biopsies by immunofluorescence. The serum of 8 patients also contained IgA-antibodies against plasmid encoded released proteins of Y. enterocolitica. This paper reports evidence for persistence of Yersinia bacilli in a group of patients with chronic enterocolitis. Further studies must show, if these results may have therapeutic implications.

Adolescent↗
PubMedDate not supplied

[A protocol for prognostic evaluation of newborns with necrotizing enterocolitis].

A modified Vásquez-Estévez protocol for prognostic appraisal of newborns with necrotizing enterocolitis was retrospectively applied to 23 confirmed cases from year 1987 throughout 1989 in general metropolitan hospital at Santiago, Chile. Cases were classified as low (0-12 points) or high (13-30) risk according to its corresponding score. Case fatality rates ranged from 7.1% to 77.7% in low and high risk groups, respectively. Sensibility was 87.5%, specificity 86.6% and efficiency 86.6%. Instrument application was easy. It concluded that this is a valuable tool for the prognostic evaluation of necrotizing enterocolitis. A wider and deeper prospective application would allow to measure more exactly its usefulness in other settings.

Enterocolitis, Pseudomembranous↗
PubMed1989

[Ulcero-necrotizing enterocolitis: the role of cytomegalovirus. Apropos of a case].

The authors report a case of Wilson-Mikity syndrome in a preterm newborn, that was followed on the 28th day of life by a necrotizing enterocolitis with colic stenosis. The finding of cytomegalic cells on the pathologic examination of the intestinal lesions, the presence of the virus on direct examination of a tissue sample, the elevated IgG levels and the presence of IgM demonstrated a cytomegalovirus infection. The authors discuss the role of this virus in the pathogenesis of the affection, either as directly responsible for the enterocolitis or as a secondary colonization of previous lesions.

Colectomy↗
PubMed1989

[Methicillin-resistant staphylococcal enterocolitis developed after induction chemotherapy in a case of acute promyelocytic leukemia].

A case of methicillin-resistant staphylococcal (MRSA) enterocolitis following combination chemotherapy for acute promyelocytic leukemia is presented. MRSA enterocolitis has characteristic clinical features of high fever, frequent vomiting and watery diarrhea, and its mortality rate is very high without a proper antibiotic therapy. When the patient with hematological malignancy has the above-mentioned clinical manifestations during antineoplastic chemotherapy, appropriate antibiotics for MRSA should be promptly begun before a bacteriological diagnosis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Total colectomy in necrotizing enterocolitis].

Total colectomy in the neonatal period, after a necrotizing enterocolitis is not infrequent and implies a series of complex attitudes towards a good adaptation of the remaining small bowel. We present 9 cases of total colectomy in children with necrotizing enterocolitis of 11 cases surgically treated out of 57 cases. We describe the different types of surgical procedures used as well as the evolution of each patient.

Colectomy↗
PubMed1989

Analysis of enteric coagulase-negative staphylococci from neonates with necrotizing enterocolitis.

We investigated the possible role of coagulase-negative staphylococci in necrotizing enterocolitis. Stool coagulase-negative staphylococci isolated from neonates during an outbreak of rotavirus-associated necrotizing enterocolitis were analyzed by a variety of techniques, including speciation, semiquantitative culturing, antimicrobial susceptibility, plasmid profiling and cytotoxicity assays. No differences were observed between the coagulase-negative staphylococci of symptomatic babies and those of asymptomatic controls.

Bacteriological Techniques↗
PubMedDate not supplied

[Post-necrotizing enterocolitis stenosis of the colon associated with cytomegalovirus infection. Description of a clinical case].

We report a case of an infant with a post-necrotizing enterocolitis stenosis, resolved with operative measures. The histologic finding of Cytomegalovirus in the resected sigmoid colon rise the question if the intestinal stricture was the proper consequence of a primary enteric viral infection or a superinfection in a transitory immunodeficiency after the acute phase of necrotizing enterocolitis.

Colonic Diseases↗
PubMed1988

[Epidemic outbreak of necrotizing enterocolitis coincident with an epidemic of neonatal rotavirus gastroenteritis].

Authors present four cases of neonatal necrotizing enterocolitis occurred during an outbreak of acute enteritis. From november 1985 to beginning of february 1986, forty-seven out of 588 newborn infants were involved. In 22 affected infants (46.8%) rotavirus were isolated from stools, whereas no bacterial or viral agent was recovered in 25 (53.2%). Four cases (8.6%) developed necrotizing enterocolitis.

Birth Weight↗
PubMed1987

Rapid diagnosis of neutropenic enterocolitis (typhlitis) by ultrasonography.

Neutropenic enterocolitis (also termed typhlitis) is an acute necrotizing process involving segments of the large and small intestine that occurs in the setting of agranulocytosis, most commonly in patients with acute leukemia. Rapid diagnosis and treatment is necessary for survival. We present a patient in whom abdominal ultrasonography revealed evidence of bowel wall thickening and ascites, confirming the diagnosis of neutropenic enterocolitis. Sonography offers a rapid, safe, and noninvasive means of diagnosis for this condition.

Agranulocytosis↗
PubMed1977

[Necrotizing enterocolitis (pediatric review)].

Necrotizing enterocolitis--a highly letal disease in the newborn period--is diagnosed in about 1--2% of the admissions to a nursery. The marcroscopic lesions are basically necroses predominantly found in the ileum, colon and jejunum. Untreated they lead to perforation, peritonitis and sepsis. The predisposing factors include such as perinatal complications, immaturity and umbilical vein catheterization; the main symptoms are bile stained vomiting and blood-streaked diarrhea, followed by signs of fulminant sepsis and peritonitis. The most typical roentgenographic findings are intramural air (pneumatosis intestinalis) and in more advanced cases pneumoperitoneum (free peritoneal air) and portal vein gas. The current plan of management--consisting of immediate withdrawal of oral feeds, gastric suction, intravenous fluid therapy, treatment of shock and administration of antibiotics--and the indication for operation are discussed. Perinatal stress and secondary bacterial invasion of the intestinal lesions seem to play an important role in the etiology of the disease. An early nutrition of the healthy immature with human breast milk seems to reduce the incidence of necrotizing enterocolitis or at least has a mitigating influence on the later course of the disease. The mortality in our own series--as reported--was high (6 patients: 1 survivor, mortality: 83%) as 4 of the patients were admitted with gross symptoms of intestinal perforation and severely shocked.

Disseminated Intravascular Coagulation↗
PubMed1988

Methyldopa hypersensitivity can mimic acute toxic enterocolitis.

The most widely known hypersensitivity reaction of methyldopa, a drug commonly used in the treatment of hypertension, is seroconversion to a positive result of a direct Coombs' test that may lead to a hemolytic anemia. The authors report a case of an infrequently noted, but serious, hypersensitivity reaction to methyldopa, manifesting primarily as acute toxic enterocolitis. A 63-year-old woman was admitted to hospital and underwent aggressive and prolonged investigation of enterocolitis. Withdrawal of methyldopa gave immediate relief of intestinal problems. Rechallenge precipitated a return of symptoms within 14 hours. It is recommended that periodic blood counts and liver function tests be done on patients treated with methyldopa for hypertension. If any abnormalities are noted the drug should be discontinued.

Acute Disease↗
PubMed1987

[A rare cause of neonatal ulcero-necrotizing enterocolitis: aortic coarctation syndrome].

The authors report a case of necrotizing enterocolitis which appeared in the first hours of life of a full-term neonate without signs of sepsis. This neonate presented with a severe hypoplasia of the horizontal aorta and very tight coarctation responsible for hepatic, renal and mesenteric ischemia. Reports of enterocolitis as a complication of congenital heart disease are rare and related most often to hypoplastic left heart than to coarctation of the aorta.

Aorta, Thoracic↗
PubMed1979

Necrotizing enterocolitis in the neonate.

Necrotizing enterocolitis has become the most common condition requiring emergency surgical treatment in the newborn infant, far surpassing all major congenital anomalies in number of presentations and in deaths after surgical treatment. No single cause for the disease is known. Necrotizing enterocolitis is characterized by ischemic necrosis of the intestine, with minimal inflammation. In 25 of 50 per cent of patients, surgical resection of gangrenous bowel is necessary. Operation is reserved for infants with intestinal perforation or grangrene. Recent refinements of indications for operation often permit surgical intervention to coincide with the advent of intestinal gangrene. At operation, expeditious resection of frankly necrotic bowel and exteriorization of the marginally viable ends is all that should be attempted. Special problems postoperatively consist of management of sepsis, maintenance of nutrition and vigilant observation for early and late complications, particularly the development of ischemic intestinal stricture.

Animals↗
PubMed1986

[Necrotizing enterocolitis. Pathogenesis and iatrogenic factors].

Following clinical observations, measurements of osmolarity of liquid drugs, and determination of blood loss due to sampling in very low birthweight infants, the following hypothesis on iatrogenic factors contributing to the pathogenesis of necrotizing enterocolitis is proposed: Due to diagnostic blood sampling during intensive care, premature infants may become severely anemic. Therefore their intestinal perfusion is reduced, causing hypoxia and hypoperfusion in the submucosa. Especially in infants with oral feeding and hyperosmolar medication, mechanical factors, hyperosmolarity and infection can affect the mucosa from the luminal side. Simultaneous hypoperfusion and hyperosmolar load may contribute to the pathogenesis of necrotizing enterocolitis. This hypothesis, which needs experimental verification, explains the different incidence of the disease in different hospitals.

Blood Volume↗
PubMed1985

[Digestive stenosis after neonatal enterocolitis].

Nineteen clinical cases of intestinal stricture due to neonatal necrotising enterocolitis and a review of available references are presented in this paper. Intestinal strictures are estimated to arise in 20% to 30% on neonatal enterocolitis. However the delay between the acute episode and the occurrence of the stenosis is variable; the depth and the extend, of the necrosis as well as inflammation and superinfection may contribute to the building up of the intestinal stricture. The histological aspects of the lesions are not unique, more over cases of spontaneously regressive stenosis are known. Question thus arising as to the most appropriate timing for surgery and the choice of surgical technics as a function of clinical aspects and of derivation of the disease are discussed in this paper.

Colonic Diseases↗