[Disorders of transit in acute pancreatitis and peritonitis].
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Ten cases of necrotizing enterocolitis occurred among 5400 infants delivered consecutively during a two and one-half year period at the Halifax Infirmary. Since this disease involved such extensive areas of the intestinal wall, medical management was employed exclusively, even when intestinal perforation occurred. Nine of the ten infants survived.In this series there was a high incidence of prematurity, prolonged interval between rupture of the placental membranes and delivery, severe asphyxia neonatorum and subsequent hypotension and metabolic acidosis. Blood cultures grew Klebsiella aerobacter or E. coli in 7/10 infants. Only two of these organisms were sensitive to kanamycin and all were resistant to ampicillin. Administration of ampicillin to the mothers did not protect these infants against necrotizing enterocolitis. Edema of the gut wall appeared to be an important early sign. Stricture formation occurred in 4/10 cases, all in the terminal ileum. These infants were operated upon only after the acute stage of the disease had subsided.
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The Deane peritoneal prosthesis has been used successfully in the treatment of 21 patients with chronic renal failure who were maintained on peritoneal dialysis for periods of up to 20 months. All patients were dialyzed for 24 hours twice weekly. While the prosthesis was still in place, transplantation was carried out in seven patients and laparotomy in three. The prosthesis was also used temporarily whenever a permanent peritoneal catheter (Tenckhoff's) failed because of infection; it was used until the signs of infection disappeared, then the permanent catheter could be replaced safely. From a total of 1136 dialyses 36 positive cultures were reported. Clinical peritonitis was found on only four occasions.
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