Objective

The objective of this study is to determine whether rapidity of death in necrotizing enterocolitis (NEC) increased odds of discordance between clinical and pathological diagnosis.

Study design

Retrospective case-series study including preterm infants admitted to the NICU.

Results

Twenty-two infants met the selection criteria. Gross pathologic evidence of NEC was present in 1/6 cases (17%) where demise occurred <12 h after onset of symptoms, 3/5 cases (60%) within 12–24 h, and 8/11 cases (73%) in >24 h. Histological evidence of necrosis was present in 4/6 (67%) cases when death occurred <12 h, 4/5 (80%) in 12–24 h, and 9/11 (82%) in >24 h. The percentage with gross pathologic evidence showed a monotonic trend (P = 0.031), while the trend was less clear for histologic findings (P = 0.496).

Conclusion

Pathologic features of cell death may not have had sufficient time to develop. This study could reassure both healthcare providers and families when pathologic and clinical diagnoses are not consistent.

中文翻译：

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新生儿坏死性小肠结肠炎：检验临床诊断与尸检结果不一致与一致的病例系列

客观的

本研究的目的是确定坏死性小肠结肠炎 (NEC) 的死亡速度是否会增加临床和病理诊断不一致的几率。

学习规划

回顾性病例系列研究，包括入住 NICU 的早产儿。

结果

22 名婴儿符合选择标准。NEC 的大体病理学证据存在于 1/6 例（17%），其中在症状出现后 12 小时内死亡，3/5 例（60%）在 12-24 小时内死亡，8/11 例（73%） > 24 小时。坏死的组织学证据出现在 4/6 (67%) 的病例中，死亡发生时间小于 12 小时，4/5 (80%) 发生在 12-24 小时内，9/11 (82%) 发生在 >24 小时内。具有大体病理证据的百分比呈单调趋势（P  = 0.031），而组织学发现的趋势不太明显（P  = 0.496）。

结论

细胞死亡的病理特征可能没有足够的时间发展。当病理和临床诊断不一致时，这项研究可以让医疗保健提供者和家属放心。