Clinicopathological profile, surgical management, and outcome of necrotising enterocolitis in children.

Authors

  • Jha Guarav Senior Resident, Department of General Surgery, Patna Medical College & Hospital, Patna, Bihar, India Author
  • Kumar Pranay Assistant Professor, Department of Pediatric Surgery, Patna Medical College & Hospital, Patna, Bihar, India Author
  • Ashish Kumar Assistant Professor, Department of Pediatric Surgery, Patna Medical College & Hospital, Patna, Bihar, India Author

DOI:

https://doi.org/10.51168/zpna0e39

Keywords:

Necrotising enterocolitis, neonatal surgery, intestinal perforation, prematurity, neonatal intensive care

Abstract

Background

Necrotizing enterocolitis (NEC) is a serious gastrointestinal emergency in neonates and infants, particularly among premature and low-birth-weight children. Early recognition and timely management are essential to reduce morbidity and mortality. This study evaluated the clinicopathological characteristics, management strategies, complications, and outcomes of children with NEC at a tertiary-care hospital.

Methods

A retrospective observational study was conducted at Patna Medical College and Hospital over a six-month period. Fourteen children diagnosed with NEC were included. Data regarding demographic characteristics, clinical presentation, management approach, complications, duration of hospitalisation, and survival outcomes were retrospectively reviewed. Patients were managed either conservatively or surgically according to clinical severity and disease progression.

Results

Among the 14 patients, 5 (35.7%) were managed conservatively, whereas 9 (64.3%) required surgical intervention. Complications occurred in 6 (42.9%) patients. The mean duration of hospitalisation was 14.2 ± 4.1 days. Overall, 10 (71.4%) patients survived, while 4 (28.6%) died. Delayed presentation was significantly associated with poor outcomes (p < 0.05). The findings indicate that patients requiring surgery represented a substantial proportion of the study population and experienced considerable morbidity.

Conclusion

NEC remains a serious neonatal surgical emergency associated with substantial morbidity and mortality. Early diagnosis, appropriate conservative management, timely surgical intervention, infection control, and adequate neonatal intensive care are essential for improving outcomes.

Recommendation

Early recognition and prompt referral of suspected NEC cases to specialised neonatal and paediatric surgical centres should be strengthened to facilitate timely intervention and improve survival.

Author Biographies

  • Jha Guarav, Senior Resident, Department of General Surgery, Patna Medical College & Hospital, Patna, Bihar, India

    is a Senior Resident in the Department of General Surgery, Patna Medical College & Hospital, Patna, Bihar, India. His professional activities include clinical surgical care and participation in academic and research activities.

  • Kumar Pranay, Assistant Professor, Department of Pediatric Surgery, Patna Medical College & Hospital, Patna, Bihar, India

    is an Assistant Professor in the Department of Pediatric Surgery, Patna Medical College & Hospital, Patna, Bihar, India. His professional activities include pediatric surgical care, clinical teaching, and academic and research activities.

  • Ashish Kumar, Assistant Professor, Department of Pediatric Surgery, Patna Medical College & Hospital, Patna, Bihar, India

    is an Assistant Professor in the Department of Pediatric Surgery, Patna Medical College & Hospital, Patna, Bihar, India. His professional activities include pediatric surgical care, academic teaching, and research activities.

References

1. Wilson RD, Johnson MP. Congenital Abdominal Wall Defects : An Update. Fetal Diagn Ther. 2004;4399:385-98.

https://doi.org/10.1159/000078990

2. Varsseveld OC Van, Pijpers AGH, Imren C, Derikx JPM, Akker CHP Van Den, Schuppen J Van, et al. Surgical outcomes for necrotizing enterocolitis in Dutch infants born before 26 weeks ' gestation. BJS Open [Internet]. 2025;9(3):1-11.

https://doi.org/10.1093/bjsopen/zraf060

3. Eeftinck LD, Musters GD, Nijssen DJ, Jonge WJ De, Vries R De, Heurn LWE Van, et al. The incidence of abdominal surgical site infections after abdominal birth defects surgery in infants : A systematic review with. J Pediatr Surg [Internet]. 2021;56(9):1547-54. Available from: https://doi.org/10.1016/j.jpedsurg.2021.01.018 https://doi.org/10.1016/j.jpedsurg.2021.01.018

4. Schattenkerk LDE, Musters GD, Nijssen DJ, Jonge WJ De, Vries R De, Heurn LWE Van, et al. Incisional hernia after surgical correction of abdominal congenital anomalies in infants : a systematic review with meta analysis. Sci Rep [Internet]. 2020;10(21170):1-10. Available from: https://doi.org/10.1038/s41598-020-77976-1https://doi.org/10.1038/s41598-020-77976-1

5. Sajankila N, Deross A, Lipman JM. Approach to the Adult Colorectal Patient with a History of Pediatric Abdominal Surgery. Clin Colon Rectal Surg. 2022;35:177-86.https://doi.org/10.1055/s-0042-1742412

6. Syed MK, Faqeeh AA Al, Saeed N, Almas T, Khedro T, Niaz MA, et al. Surgical Versus Medical Management of Necrotizing Enterocolitis With and Without Intestinal Perforation : A Retrospective Chart Review. Cureus. 2021;13(6):1-8.

https://doi.org/10.7759/cureus.15722

7. Gao J, Lai D, Tou J. Survey on surgical treatment of neonatal necrotizing enterocolitis in China 2022. World J Pediatr Surg. 2023;6(July):1-7.https://doi.org/10.1136/wjps-2023-000588

8. Devi U, Bethou A. Refining Surgical Risk Assessment in Necrotising Enterocolitis - A Nomogram-Based Approach. Indian J Pediatr. 2025;92(7):693-4.

https://doi.org/10.1007/s12098-025-05551-5

9. Bethell GS, Jones IH, Battersby C, Knight M, Hall NJ. Methods of identifying surgical Necrotizing Enterocolitis - a systematic review and meta-analysis. Pediatr Res [Internet]. 2024;97(April):45-55. Available from: http://dx.doi.org/10.1038/s41390-024-03292-3 https://doi.org/10.1038/s41390-024-03292-3

10. Schattenkerk LDE, Musters GD, Nijssen DJ, Jonge WJ De, Vries R De, Heurn LWE Van, et al. The incidence of different forms of ileus following surgery for abdominal birth defects in infants : a systematic review with a meta-analysis method. nnov Surg Sci. 2021;6(4):127-50.https://doi.org/10.1515/iss-2020-0042

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Published

2026-08-30

Issue

Section

Section of Pediatric Surgery

How to Cite

Clinicopathological profile, surgical management, and outcome of necrotising enterocolitis in children. (J. Guarav, K. Pranay, & A. Kumar, Trans.). (2026). SJ Pediatrics and Child Health Africa, 3(3), 9. https://doi.org/10.51168/zpna0e39

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