S. Federici and L. De Biagi *
Necrotizing enterocolitis (NEC) is a significant complication for premature newborns. Infants who survive NEC are at increased risk of having poor long-term physiological and neurodevelopmental growth. The objective of this paper is to give a comprehensive description of the long-term consequences of NEC. Despite the rise in incidence of NEC there is a paucity of data regarding long-term outcomes of these infants that can be divided into two groups. The first group includes gastrointestinal complications that could occur in relation to the bowel disease, the surgical treatment and quality of the residual bowel. These complications are strictures and short bowel syndrome (SBS). Intestinal strictures are a common occurance after recovery from NEC that should be investigated with a contrast study in case of suspicious clinical findings or before reversal ostomy. If the study demonstrates a stricture in a symptomatic patient, resection with anastomosis is needed. SBS is the result of a massive intestinal resection or of a dysfunctional residual bowel and it can occur in a fourth of patients affected by NEC. The second group includes neurodevelopmental impairment and growth. Neurodevelopmental outcomes in patients with NEC have not been widely reported. Infants with NEC are at high risk for adverse neurodevelopmental outcomes whose cause can be multifactorial and linked to perinatal events, severity of disease, surgical treatment and its complications and hospitalization. Understanding the morbidity of NEC with a long-term follow-up would aid neonatologists and pediatric surgeons to make informed decisions in providing care for these patients. Further research on this topic is needed.
Necrotizing enterocolitis, outcome, Strictures, short bowel syndrome, neurodevelopmental impairment
Pediatric surgery Unit – INFERMI Hospital- Rimini, Pediatric surgery Unit – INFERMI Hospital- Rimini