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2015 ; 35
(9
): 755-62
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Depth of bacterial invasion in resected intestinal tissue predicts mortality in
surgical necrotizing enterocolitis
#MMPMID25950918
Remon JI
; Amin SC
; Mehendale SR
; Rao R
; Luciano AA
; Garzon SA
; Maheshwari A
J Perinatol
2015[Sep]; 35
(9
): 755-62
PMID25950918
show ga
OBJECTIVE: Up to a third of all infants who develop necrotizing enterocolitis
(NEC) require surgical resection of necrotic bowel. We hypothesized that the
histopathological findings in surgically resected bowel can predict the clinical
outcome of these infants. STUDY DESIGN: We reviewed the medical records and
archived pathology specimens from all patients who underwent bowel
resection/autopsy for NEC at a regional referral center over a 10-year period.
Pathology specimens were graded for the depth and severity of necrosis,
inflammation, bacteria invasion and pneumatosis, and histopathological findings
were correlated with clinical outcomes. RESULT: We performed clinico-pathological
analysis on 33 infants with confirmed NEC, of which 18 (54.5%) died. Depth of
bacterial invasion in resected intestinal tissue predicted death from NEC (odds
ratio 5.39 per unit change in the depth of bacterial invasion, 95% confidence
interval 1.33 to 21.73). The presence of transmural necrosis and bacteria in the
surgical margins of resected bowel was also associated with increased mortality.
CONCLUSION: Depth of bacterial invasion in resected intestinal tissue predicts
mortality in surgical NEC.