DIFFERENTIATED APPROACH TO THE SURGICAL TREATMENT OF ULCERATIVE-NECROTIC ENTEROCOLITIS IN NEWBORNS
Keywords:
ulcerative-necrotic enterocolitis, newborns, surgical treatment, intestinal perforation, necrosis, inflammation, morphology, diagnosis, neonatal surgeryAbstract
Ulcerative-necrotic enterocolitis is one of the most severe gastrointestinal diseases in newborns, predominantly affecting premature and low-birth-weight infants. The disease is characterized by inflammatory and necrotic damage to the intestinal wall with a high risk of perforation and severe complications. This study presents a differentiated approach to the surgical treatment of ulcerative-necrotic enterocolitis in newborns based on clinical, instrumental, and morphological findings. Clinical manifestations, laboratory indicators, radiological data, and morphological changes of the intestinal wall were analyzed. Severe necrotic lesions, inflammatory infiltration, microcirculatory disturbances, and intestinal perforations were identified as the main indications for surgical intervention. The differentiated surgical approach allowed optimization of treatment tactics depending on the severity and extent of intestinal damage. The obtained results demonstrate the importance of early diagnosis and timely surgical management in reducing complications and improving survival rates in newborns with ulcerative-necrotic enterocolitis.
References
Neu J, Walker WA. Necrotizing enterocolitis. New England Journal of Medicine. 2011;364:255–264.
Hackam DJ, Caplan MS. Necrotizing enterocolitis: pathophysiology and current management. Seminars in Pediatric Surgery. 2018;27:7–17.
Bell MJ et al. Neonatal necrotizing enterocolitis: therapeutic decisions based upon clinical staging. Annals of Surgery. 1978;187:1–7.
Lin PW, Stoll BJ. Necrotising enterocolitis. Lancet. 2006;368:1271–1283.
Henry MC, Moss RL. Surgical therapy for necrotizing enterocolitis. Clinics in Perinatology. 2004;31:459–476.
Epelman M et al. Necrotizing enterocolitis: review of imaging findings. Radiographics. 2007;27:285–305.
Kim JH. Role of ultrasonography in necrotizing enterocolitis. Pediatric Radiology. 2005;35:1052–1060.
Maheshwari A. Immunologic mechanisms in necrotizing enterocolitis. Seminars in Pediatric Surgery. 2018;27:25–31.
Hunter CJ et al. Enterocyte apoptosis in necrotizing enterocolitis. Pediatric Research. 2008;63:632–637.
Patel RM, Denning PW. Intestinal microbiota and necrotizing enterocolitis. Clinics in Perinatology. 2013;40:11–25.
Sharma R et al. Microcirculatory changes in necrotizing enterocolitis. Journal of Pediatric Surgery. 2007;42:1231–1238.
Ng PC. Diagnostic markers of neonatal infection. Archives of Disease in Childhood. 2004;89:229–235.
Gordon PV. Understanding intestinal vulnerability in premature infants. Pediatric Research. 2009;65:138–144.
Berman L, Moss RL. Necrotizing enterocolitis: update and future directions. Seminars in Fetal and Neonatal Medicine. 2011;16:145–150.
Caplan MS, Jilling T. New concepts in necrotizing enterocolitis. Current Opinion in Pediatrics. 2001;13:111–115.
Azerbaijan
Türkiye
Uzbekistan
Kazakhstan
Turkmenistan
Kyrgyzstan
Republic of Korea
Japan
India
United States of America
Kosovo