Dahreddine M, Fremond B, Babut J M
Service de Chirurgie Infantile, CHU Averroes, Casablanca, Maroc.
Ann Chir. 1995;49(10):950-3.
Over a 10-year period, the authors followed the course of 112 neonates treated for primary acute necrotizing enterocolitis. Ten cases of gastrointestinal stricture were diagnosed, regardless of initial treatment, after an interval of 20 days to 6 months. The site of the stricture was colonic in 6 patients, ileal in three other patients and ileal and colonic in the remaining patient. The stricture was treated surgically in 9 patients (resection-anastomosis in 6 cases, resection with gastrointestinal diversion in 2 cases and isolated gastrointestinal diversion in 1 case). A follow-up barium enema in 1 patient showed spontaneous resolution of the stricture. With a mean follow-up of 5 years, the over all result was considered to be good in 7 cases and poor in one case. Two deaths were observed, one on the 10th day and the other at the 3rd postoperative day. These complications appeared to be related to the delayed diagnosis and treatment of the stricture.
在10年期间,作者对112例接受原发性急性坏死性小肠结肠炎治疗的新生儿的病程进行了跟踪。在间隔20天至6个月后,无论初始治疗如何,共诊断出10例胃肠道狭窄。6例患者的狭窄部位在结肠,另外3例在回肠,其余1例在回肠和结肠。9例患者接受了手术治疗(6例行切除吻合术,2例行切除加胃肠改道术,1例行单纯胃肠改道术)。1例患者的随访钡剂灌肠显示狭窄自行缓解。平均随访5年,7例总体结果良好,1例较差。观察到2例死亡,1例在第10天,另1例在术后第3天。这些并发症似乎与狭窄的诊断和治疗延迟有关。