2016 Volume 52 Issue 5 Pages 1037-1041
Purpose: To clarify the clinical picture of necrotizing enterocolitis (NEC) in neonates with major congenital heart disease (CHD).
Methods: Regarding six such cases during the last 21 years, we retrospectively reviewed their medical charts, including demographics, type of CHD and surgical or transcatheter intervention for it, change in hemodynamics before/after intervention and at NEC onset, age at NEC onset, episodes of hypoxia, interval between NEC onset to the primary operation and type of operation for it, localization of NEC, and survival.
Results: The median birth weight and gestational age were 2,614 g and 38.4 weeks, respectively: four were male. All had cyanotic heart diseases and four underwent surgical or transcatheter intervention for the CHD before the NEC. Treatment of the NEC started at the median age of 8.5 days. One experienced shock and another experienced anoxic spells immediately before the onset of NEC. After intervention, arterial oxygen saturation was elevated in all the patients and blood pressure decreased in three patients at NEC onset. The median NEC onset age was 12 days. Abdominal drainage (n = 1), colostomy (n = 2), ileostomy with drainage (n = 2), and ileostomy with resection of necrotic intestine (n = 1) were the primary operations for the NEC. The median interval between the NEC onset and the primary operation was 8 days. The colon was involved in the NEC in all the patients. Five patients survived.
Conclusions: CHD could be a risk factor for NEC even in mature neonates. The timing and modality of surgical intervention for NEC are crucial for survival.
