Clinical Features And Management Of Intestinal Strictures After Neonatal Necrotizing Enterocolitis:Retrospective Study Of 79 Cases

ObjectiveTo study the clinical features and treatment experience of intestinal stricture after neonatal necrotizing enterocolitis.MethodsClinical data of 79 cases was studied retrospectively from April 2014 to June 2018.Of the 79 cases,20 cases with NEC Bell stage I,52 cases with Bell stage II and 7 cases with Bell stage III.All the cases underwent preoperative X-Ray,73 cases with gastrointestinal contrast study and 69 cases with rectal mucosal biopsy.ResultsA mean time of intestinal stricture after neonatal necrotizing enterocolitis was 46.5 days.In 79 patients,73 cases underwent gastrointestinal contrast study,with 58 showing intestinal stenosis,6 cases with fetal colon.69 cases underwent rectal mucosal biopsy,with 3 casesshowing Hirschsprung disease.Most intestinal stenosis were found in the ascending colon,transverse colon and descending colon,32 cases had multiple stenosis.In 79 cases,71 cases with resection of stricture and primary end to-end anastomosis.73 cases were followed up,3 cases had postoperative adhesions,2 underwent conservative treatment,and 1underwent second operation.8 cases suffered from malnutrition and dehydration due to repeated diarrhea.They were admitted to the hospital1-3 times and eventually recovered.The rest of the children have a good recovery.No recurrent stricture was seen.ConclusionsIntestinal stenosis after neonatal necrotizing enterocolitis was mostly happened in the colon,some cases have multiple strictures.Gastrointestinal contrast study was the preferred method of examination.Preoperative rectal mucosal biopsy can find Hirschsprung disease,and choose a reasonable treatment plan.The main treatment was resection of stricture and primary end to-end anastomosis,and the prognosis was good.