What is the incidence of intestinal stricture in necrotizing enterocolitis (NEC)?

Updated: Dec 27, 2017
  • Author: Shelley C Springer, JD, MD, MSc, MBA, FAAP; Chief Editor: Muhammad Aslam, MD  more...
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Answer

This complication, the incidence of which is 25-33%, can develop in infants with or without a preceding perforation. Intestinal stricture occurs when an area of intestinal ischemia heals with resultant fibrosis and scar formation that impinges on the diameter of the lumen. The most common site of stricture is the left colon, followed by the terminal ileum.

Intestinal stricture is most common in infants treated nonoperatively, because infants treated operatively commonly undergo contrast enema before closure of the ostomy, and any area of stricture is resected when the ostomy is closed.

Intestinal stricture should be suspected in any infant who receives nonoperative treatment for NEC and who fails to thrive and/or has bloody stools or bowel obstruction. Symptoms of feeding intolerance and bowel obstruction typically occur 2-3 weeks after recovery from the initial event.


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