No abstract

SummaryEleven premature babies developed necrotizing enterocolitis in an epidemic of gastroenteritis and salmonella infection. This occurred in one of two premature baby wards over a period of 10 weeks. All affected babies had severe gastroenteritis and six had salmonella infection. No cases of necrotizing enterocolitis occurred in the unaffected ward during the same period. All other possible factors which might have predisposed to necrotizing enterocolitis occurred with equal frequency in both wards.There seems little doubt that infection was the significant factor in the pathogenesis.

A retrospective analysis of a series of 63 cases of gastroschisis managed over an 11-year period distinguished a single statistically significant prognostic factor. There were 6 (9.5%) deaths, of which 4 occurred in the 8 infants with small-bowel atresia/stenosis (P < 0.005, Fisher's exact test). One died at 48 h and the remaining 3 of liver disease related to total parenteral nutrition. Of the 4 survivors, 1 developed a late biliary stricture necessitating hepaticoenterostomy but is alive and well aged 4 years. The remaining 3, following initially prolonged hospitalisations and multiple operations, are alive and well after 2, 4 and 7 years. In 3 patients the atresia was not detected at the primary operation. The small number of cases of gastroschisis-associated small-bowel atresia seen in any one unit may conceal the importance of the problem, and limits experience in the approach to management.