Diagnosis and treatment of necrotizing enterocolitis. A retrospective evaluation of abdominal paracentesis and continuous postoperative lavage

From 1980 to 1991, 70 preterm and 20 term infants suffering from necrotizing enterocolitis (NEC) were treated at the University of Ulm hospitals. NEC was primarily suspected from clinical signs. The diagnosis was established by plain abdominal X-rays, infection markers and abdominal paracentesis. Indication for surgery resulted from paracentesis, from radiologically proven perforation, from ileus symptoms and from rapid clinical deterioration; 44 preterm and 7 term infants underwent surgery. Bowel resections were performed in 5 of the term and in 16 of the preterm infants. An enterostomy was fashioned in 33 cases. Total necrosis of the gut was apparent in 8 infants. A continuous peritoneal lavage was performed in 34 babies. One term and 18 preterm babies, all with a birth weight less than 1000 g, died. This results in a NEC-related overall mortality of 19%.