Colonic strictures following successful medical management of necrotizing enterocolitis: A prospective study evaluating early gastrointestinal contrast studies

Outcomes of diverting jejunostomy for severe necrotizing enterocolitis

“…This is a lower incidence than is usual in infants with NEC of variable extent where stricture rates of around 18% have been reported [13,14]. This lower rate could be because of the small number of patients in our series of extensive NEC and partly because of the fact that the 6 infants who did not survive could have potentially have the most severe NEC and could have developed an intestinal stricture.…”

“…We performed a contrast study of the distal part of bowel before jejunostomy closure in all survivors to exclude the presence of a stricture. It has previously been reported that intestinal strictures, commonly occurring in the colon, can develop from 3 weeks up to 3 months post-NEC and are best demonstrable on a contrast enema [13,15]. Traditionally, they have been resected at laparotomy as in our case [15][16][17].…”

Severe Thrombocytopenia Predicts Outcome in Neonates with Necrotizing Enterocolitis

“…[1][2][3][4][5][6][7][8][9] Survivors often suffer extensive morbidity that includes intestinal stricture (15-30%), short bowel syndrome requiring prolonged parenteral nutrition, and cholestatic liver disease (50-60%). 1,[3][4][5][6][7][8][9][10][11][12][13][14][15] Many infants with Bell stage II or III NEC require surgery. Surgical indications include bowel perforation, worsening clinical status despite maximal medical therapy, and stricture.…”

Preoperative distal loop contrast radiograph before closure of an enterostomy in paediatric surgical patients. How much does it affect the procedure or predict early postoperative complications?

“…NEC-associated postinflammatory bowel strictures may occur in 32-40% of babies with surgically treated NEC [2,19] and also in 14-18% of babies with medically treated NEC [10,20]. If the real risk of strictures is as high as reported [2,19], performance of DLCR seems sensible.…”

“…To ascertain unhindered intestinal passage after the closure of the enterostomy, and to detect signs of disease-specific complications, and to assess the need of surgery in addition to the mere closure of the enterostomy, a distal loop contrast radiograph (DLCR) is widely used. DLCR has been considered particularly useful for cases in which the underlying disease, such as NEC or inflammatory bowel disease, may cause strictures or fistulae in the bowel distal to the enterostomy [8][9][10][11]. In adult surgery for intestinal diseases or for injuries of the rectum and colon have questioned the value of DLCR.…”