Necrotising enterocolitis: Case series, of General Hospital of Mexico Dr. Eduardo Liceaga

Background

Necrotising enterocolitis (NEC) is an acute inflammatory condition of the colon involving a wide range of diseases with one end result: necrosis. This disease entity is very common in preterm infants, since 5–10% of premature babies weighing less than 1.5 kg are believed to suffer from it, and it has a mortality rate of around 50% of cases.

Objective

To describe the clinical and pathological characteristics of 24 patients with an established diagnosis of NEC and to identify their characteristics in terms of demographics, concomitant diagnoses and treatment response in order to provide preliminary data for designing prospective studies and future medical interventions.

Materials and methods

Information for 24 autopsied neonates who died of complications of NEC between 1993 and 2013 was compiled and analysed retrospectively.

Results

Of all 24 cases diagnosed with necrotising enterocolitis, only 15 were diagnosed clinically; all others (9 cases) were diagnosed post mortem. During autopsy, the most common finding was bleeding in different gastrointestinal segments (n = 13 patients [53.9%]), followed by necrosis (n = 9 [37.5%]) and perforation (n = 10 [41.6%]). Four of the eight cases in which the Bell's clinical stage was reported could not be correlated with the pathological findings.

Conclusions

As NEC is a disease with a high mortality rate, it is necessary to increase our knowledge of the demographic and clinical characteristics of patients with the disease to make a diagnosis that enables the patient to have early access to efficient therapeutic interventions. Our results demonstrate broad difficulty in the clinical diagnosis of this condition, as well as a weak relationship between the clinical stage reported and the pathological characteristics found during autopsy. The significance of this case series lies in its demonstration of the lack of accurate knowledge and identification of the clinical and demographic characteristics of patients with necrotising enterocolitis and the need for greater understanding of the pathophysiological foundations of this disease.