[Necrotizing enterocolitis. A study of forty-six cases seen in a maternity hospital].

Lebrun, F; Amiel-Tison, C; Sureau, C

Forty-six cases of necrotizing enterocolitis were seen at the Baudelocque maternity hospital from august 1978 to october 1980. In eighteen cases, clinical signs associated with roentgenograms showing pneumatosis led to unequivocal diagnosis. A surgical procedure was done in nine of these patients, during the acute stage in four and later on in five. Diagnosis was strongly suspected in twenty-eight cases. Clinical features were less serious and included abdominal distension, bloody stools, and emesis. There were no roentgenological signs. None of these infants underwent surgery. Overall mortality rate was 7% (3/46). In comparison to previously published studies, our series shows lower perinatal risk factors, higher mean birthweight, and lower prematurity rate (14%). No evidence was found to support the responsibility of a specific bacterial agent. Corona virus was found in the stools of five out of eleven cases studied during the second epidemic wave in october 1979, suggesting a possible viral etiology. Several preventive steps have been taken. Breast-feeding has been encouraged. Each mother-infant pair has been isolated instead of grouping infants in night nurseries. Staff members have been given specific information on the means of preventing contamination.