Treatment of Necrotizing Enterocolitis

• Published in: The New England journal of medicine Vol. 355; no. 8; pp. 846 - 847
• Main Author: Gordon, Phillip V
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 24-08-2006
• Subjects: Diagnosis, Differential; Enterocolitis, Necrotizing - diagnosis; Enterocolitis, Necrotizing - therapy; Humans; Infant, Newborn; Infant, Premature, Diseases - therapy; Infant, Very Low Birth Weight; Intestinal Perforation - diagnosis; Intestinal Perforation - therapy; Pneumatosis Cystoides Intestinalis
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMc061678

To the Editor:
The study by Moss et al. (May 25 issue)
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is impressive because it represents a successful multicenter, prospective, randomized trial investigating therapies for necrotizing enterocolitis. However, 60 percent of the study cohort did not have evidence of pneumatosis on radiography, 77 percent weighed less than 1000 g at birth, 30 percent were not receiving enteral feeding before perforation occurred, and more than 30 percent had perforation within the first two weeks after birth. These features suggest a diagnosis of spontaneous intestinal perforation rather than necrotizing enterocolitis.
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Several investigators have reported better outcomes with spontaneous intestinal perforation . . .