Post Necrotizing Enterocolitis Colonic Strictures: Report of 5 Cases
Background: With increasing survival of patients suffering from necrotizing enterocolitis (NEC) colonic strictures, as its late sequelae, is increasingly being seen and most of these patients present with chronic constipation.
Case Series: Five patients of acquired colonic stricture presenting with abdominal distension and constipation are being reported here. All five patients varied in clinical features, age at presentation and surgical manage-ment. Three of them had abdominal distension and constipation with poor nutritional status. Primary resection with anastomosis could be done in only one while stoma was made initially in other patients. One patient pre-sented with sealed perforation and fistula between jejunum and colon. All, except one patient, had stricture at splenic flexure. Histopathology of colon reported normal ganglion cells in all patients.
Conclusion: All survivors of necrotizing enterocolitis, should be followed for the development of colonic stricture; It should be kept as important differential diagnoses of chronic constipation in children.
Oldham KT, Arca MJ. From Atresia, Stricture, and other Obstructions of the colon. In: Pediatric Surgery. Volume 2. 6th edition. Edited by Grosfeld JL, O’Neill JA, Jr. Fon-kalsrud EW, Coran AG.Philadelphia: Elsevier; 2006;1494-5.
Phad N, Trivedi A, Todd D, Lakkundi A. Intestinal strictures post-necrotising enterocolitis: clinical profile and risk fac-tors. J Neonat Surg. 2014; 3: 44.
Zhang H, Chen J, Wang Y, Deng C, Li L, Guo C. Predictive factors and clinical practice profile for strictures post-necrotising enterocolitis. Medicine. 2017;96:e6273.
Jainik JS, Ein SH, Mancer K. Intestinal stricture after ne-crotizing enterocolitis. J Pediatr Surg.1981; 16:438-43.
BakerSS, Liptak GS, Colletti RB, Croffie JM,DiLorenzo C, Ector W, et al. Constipation in infants and children: evalua-tion and treatment. A medical position statement of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr. 1999;29:612-26.
Kumar C, Luthra M. Cytomegalovirus as a cause of colonic stricture-simulating Hirschsprung’s disease. J Indian Assoc Pediatr Surg. 2018;23:103-5.
Mirza B, Iqbal S, Ijaz L. Colonic atresia and stenosis:our experience.J Neonat Surg. 2012; 1: 4.
Pan P. Delayed presentation of colonic atresia masquerad-ing constipation. Southeast Asian J Case Rep Rev. 2017; 6:2664-5.
Ragavan M, Arunkumar S, Balaji NS. Segmental dilatation of near total colon managed by colon preserving surgery. APSP J Case Rep. 2012; 3:18.
Gobet R, Sacher P, Schwobel MG. Surgical procedures in colonic strictures after necrotizing enterocolitis. Acta Pae-diatrica.1994; 396:77-9..
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