만삭아에 발생한 괴사성 장염

김대연; 김성철; 김경모; 김애란; 김기수; 피수영; 김인구

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자료유형: 학술저널

저자정보: 김대연 (울산대학교 의과대학 서울중앙병원 외과학교실) 김성철 (울산대학교 의과대학 서울중앙병원 외과학교실) 김경모 (울산대학교 의과대학 서울중앙병원 소아과학교실) 김애란 (울산대학교 의과대학 서울중앙병원 소아과학교실) 김기수 (울산대학교 의과대학 서울중앙병원 소아과학교실) 피수영 (울산대학교 의과대학 서울중앙병원 소아과학교실) 김인구 (울산대학교 의과대학 서울중앙병원 외과학교실)

저널정보: 대한소아외과학회 Journal of the Korean Association of Pediatric Surgeons : JKAPS Journal of the Korean Association of Pediatric Surgeons : JKAPS 제9권 제1호

발행연도: 2003.1

수록면: 19 - 23 (5page)

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Necrotizing Enterocolitis (NEC) is usually a disease of premature infants, but occasionally it affects the term neonate. Twenty-five infants with NEC were treated at Asan Medical Center between January 2000 and December 2002, and 13 of them were term infants. In each case, the diagnosis of NEC was established by a clinical illness fulfilling the Bell's stage II or III NEC as modified by Walsh or by surgical findings. There were six males and seven females. The birth weight was from 1,960 to 3,700 g. The age at diagnosis was from 1 to 40 days. Four patients had congenital heart disease: one of who had hypothyroidism and cleft palate. Abdominal distension was present in all, and bloody stools in four. One patient had history of hypoglycemia, three had Rota viral infection. Eight patients had leucopoenia (<$5.0{\times}10^9/L$), seven had thrombocytopenia (<$100{\times}10^9/L$), and three severe thrombocytopenia (<$50{\times}10^9/L$). Laparotomy was required in 10 of the 13 patients. Indications for operation in the acute phase were failure to respond to aggressive medical therapy in five, and perforation in three patients. There were two late phase operations for intestinal stricture and fistula. There were no operative complications. Ten of thirteen patients survived (76.9%). Two patients died of septic complication. There was a delayed death due to heart failure. There was a significant difference in survival according to platelet count ($50{\times}10^9/L$) (p<0.05). Congenital heart disease and Rota viral infection are associated with NEC in term infants and thrombocytopenia and leucopoenia may be surgical indications.

#Necrotizing enterocolitis #Term infant

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