Necrotizing Enterocolitis in the Premature Infant

Abstract

Roentgenographic and pathologic findings reveal the intestine dilated with gas bubbles in the subserosa and submucosa; the portal vein may be air-filled. A barium-enema pattern mimicking aganglionic megacolon may be demonstrated. Single and multiple perforations with pneumoperitoneum are common. The enterocolitis is of unknown etiology; gross vascular occlusion or prior intestinal obstruction has been absent. Speculations on the role of bacterial endotoxin in producing such lesions are presented. The air bubbles are a sign, as is the free air or portal-vein air, of the basic necrotizing enterocolitis, and not a disease per se. If noted locally, they may indicate a surgically resectable localized lesion; unfortunately most patients will die of sepsis.