Abstract
We report the case of a boy who developed necrotizing enterocolitis (NEC) secondary to non-IgE-mediated gastrointestinal food allergy (non-IgE-GI-FA) in neonates and infants after surgery for intestinal atresia. The patient was a 38-day-old boy who was born full term with a birth weight of 2,926 g. He had undergone radical surgery for intestinal atresia on day 1 after birth. Although he had started feeding on breast milk and the neonatal formula New MA-1® before the surgery, abdominal distention was observed. On day 38, he presented with marked abdominal distention and shock. Emergency laparotomy demonstrated extensive necrosis of the small bowel. After the operation, he developed short bowel syndrome. His postoperative course was uneventful. He was given a combination of Elemental formula® and cyclic total parenteral nutrition after surgery, which resulted in good weight gain. In view of his preoperative course, operative record, and pathological findings, we opined that non-IgE-GI-FA caused NEC. A history of gastrointestinal surgery in neonates increases the risk of non-IgE-GI-FA, which in turn increases the risk of developing NEC even in full-term infants. It is important to prevent the onset of NEC by removing milk protein exposure when symptoms of non-IgE-GI-FA are first observed.
