Þarmadrepsbólga nýbura á Íslandi

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open All cases of neonatal necrotizing enterocolitis in Iceland in 1976-1991 were reviewed. The diagnosis was searched for in the records of the departments of neonatology and pathology. The records of the 23...

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Bibliographic Details
Main Authors: Atli Dagbjartsson, Jóhann Heiðar Jóhannsson, Anna Björg Halldórsdóttir, Guðmundur Bjarnason, Gunnar Biering
Format: Article in Journal/Newspaper
Language:Icelandic
Published: Læknafélag Íslands, Læknafélag Reykjavíkur 2009
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Online Access:http://hdl.handle.net/2336/78174
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Summary:Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open All cases of neonatal necrotizing enterocolitis in Iceland in 1976-1991 were reviewed. The diagnosis was searched for in the records of the departments of neonatology and pathology. The records of the 23 cases retrieved were all reviewed by the authors. Neonatal necrotizing enterocolitis in Iceland appeared as five sporadic cases in 1976-1985 and an epidemic of 18 cases in 1987-1990. This corresponds to an incidence of 0.12% in neonates in Iceland in the former period and 1% during the period of the epidemic. In this group of patients there were nine boys and 14 girls, with an average birthweight of 2266 gm (range 530-4286) and a gestational age of 33.7 weeks (range 24-42). Two (9%) had severe congenital malformations. Various pregnancy complications were found, including maternal preeclampsia, essential hypertension, diabetes, fever, urinary tract infection and early rupture of membranes. The placental histology had been studied in 10 cases, and 80% of these revealed abnormalities, i.e. significant degenerative changes, infarcts or acute inflammation. The average postnatal age at diagnosis was 8.7 days (range 1-26), 10 days for the five sporadic cases and 8.3 days during the epidemic. Conventional risk factors identified included oral feedings (87%), prematurity (70%), perinatal hypoxia (61%), acute Cesarean-section (48%), respiratory distress (43%) and an umbilical catheterization (43%). The most common clinical signs in this group of patients were bloody stools (70%), silent abdomen (57%), vomiting (52%) and abdominal distention (43%). The X-ray signs included thick-walled intestines (86%), intestinal pneumatosis (76%), dilated intestinal loops (71%) and fluid (52%) or gas (29%) in the peritoneal cavity. Bacterial cultures, taken from various sites at diagnosis of the disease in 21 children, revealed bacterial growth in 15 of the 52 specimens, but these were considered non-significant and there was no evidence ...