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March 1974

Neonatal Necrotizing Enterocolitis

Author Affiliations

Professor and Chief of Pediatric Surgery University of Virginia Charlottesville, VA 22901

Am J Dis Child. 1974;127(3):444. doi:10.1001/archpedi.1974.02110220142028

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To the Editor.—The article by Joshi et al in the Journal (126:113, 1973) represents a nice contribution to the developing pathological picture of neonatal necrotizing enterocolitis. It may be, as the authors suggest, that "... a less aggressive approach toward the surgical resection of the intestine than is usually advocated, would seem warranted." However, to a surgeon, the authors' cases seem to suggest just the opposite. In case 1, vigorous medical management gave only transient improvement, which was followed by frank perforation of the colon. Earlier surgical intervention might have avoided the perforation and peritonitis and possibly have shortened the hospital course. However, the infant survived, and it is hard to quarrel with success in this case. In case 2, a limited resection was done at the first operative procedure ("a less aggressive approach," if you will) and a second operation was found necessary to deal with either extension of

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