الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Neonatal necrotizing enterocolitis (NEC) remains the most common gastrointestinal emergency encountered in the NICU. Despite the significant morbidity and mortality of NEC, its pathogenesis remains largely unknown. Prematurity remains the main risk factor for development of NEC.
In our study, we received 54 cases in NICU and Pediatric Surgery Unit at El Shatby Children Hospital. Thirty-five were males (64.8 %) and 19 were females (35.2 %). Most of our patients (77.8%) were preterm, especially ranging between 30-36 weeks of gestation. Regarding birth weight, the range was (750-3700 g) with 53.7% of cases were below 1,500 kg.
Most of our patients were presented by abdominal distension (96.3%), followed by increased gastric residues and bilious vomiting followed by signs of neonatal sepsis.
The most important laboratory finding was thrombocytopenia which was present in all surgical cases, as well as elevated CRP. Metabolic acidosis was seen in 94.7% of the surgical cases.
Plain X-ray on abdomen in erect position was done for all cases. The most common radiological finding was pneumatosis intestinalis which was present in 46.3% of cases. The most important finding was pneumoperitoneum as it is considered an absolute indication for laparotomy.
Patients were classified into 3 groups according to modified Bell’s staging system. Stage I and II included 35 cases (64.8%). All cases were treated conservatively with survival of 29 cases of them (82.9%).
On the other hand, stage III included 19 cases and surgical intervention was mandatory for them. Twelve cases out of 19 (63.2%) had fair general condition and were managed by immediate laparotomy. The remaining 7 cases (36.8 %) were of bad condition and were managed by peritoneal drainage with 2 cases showed complete improvement, 2 cases showed deterioration in general condition and underwent laparotomy while 3 cases died within 48 hours after drain.