Clinical versus laboratory parameters for prediction of disease progression in surgical necrotizing enterocolitis

Aim: To evaluate our experience in management of surgical NEC and whether clinical or laboratory parameter can predict the progression of disease in surgical NEC Patient and methods: Retrospective study was cared on 30 patients with surgical necrotizing enterocolitis in the form of abdominal wall erythema, positive paracentesis , abdominal lump and bowel perforation were included ,patients developing enterocolitis after surgery were excluded. The patients were evaluated with clinical, laboratory and radiological parameters .These include age at presentation, stage, symptoms and sign at presentation with laboratory parameters of blood counts, pH, base deficit, platelet counts, electrolytes and random blood sugar levels. A comparison was done between clinical and laboratory parameters, and between survival and non survival patients and also between operated and non operated patients. Results: There were 25 males and 5 females patients with mean birth weight of 1.9 kg .Age at presentation ranged from 3 to 20 days (mean: 9.3 days) . Mortality was 33.3%.The neonates with severe disease had abdominal distention with wall erythema .43.3% of patients had shock at the time of presentation, also it was observed that neonates with acidosis and higher base deficit and had progressive fall in platelets counts had more chance of requirement of laparotomy. There was no statistical difference in birth weight, gestational age, total leukocyte count, serum electrolytes, blood sugar and other measured parameters. Also neonate not presenting with shock were more likely to survive. Conclusion: Clinical parameter assessment still remains the best to predict the disease progression in surgical necrotizing enterocolitis .