Objective: : Necrotizing enterocolitis (NEC) has become the most common gastrointestinal emergenc... more Objective: : Necrotizing enterocolitis (NEC) has become the most common gastrointestinal emergency among neonates and preterms admitted to the intensive care units. The aim of this study is to evaluate the surgical management of NEC as well as their outcome. Patients and methods: : Thirty five cases were included in this prospective study (10 full terms, 15 preterm and 10 infants) with the diagnosis of NEC. The severity of NEC episodes were determined according to Bells classification into group A (stage I 10 cases), Group B (stage II 17 cases) and group C (stage III 8 cases). Full history and clinical examination were taken. Radiological studies (abdominal plain X-ray and ultrasound), blood and stool cultures were done. Results: : All risk factors such as sepsis, hypoxia, premature rupture of membrane (PROM) and eclampsia were statistically significantly higher among group C than group A. The commonest presenting symptom was abdominal distension followed by vomiting. All positive radiological signs were statistically significantly higher among both groups B&C than group A except for pneumopritonium sign. Medical treatment was started and complete clinical improvement was achieved in all cases of group A and in 2 cases from group B. The remaining 23 cases (15 cases from group B and the 8 cases of group C) failed to respond to the medical treatment and were operated upon. Resection anastomosis was done for 12 cases from group B while resection with stoma formation was done for 3 cases from group B and 8 cases from group C. The over all mortality was 11 cases out of 35 (31.4%). 5 cases from group B and 6 cases from group C. Conclusions: : Early diagnosis and intensive medical and surgical treatment with laparotomy and resection of the affected bowel were mandatory to minimize both morbidity and mortality from NEC. Primary anastomosis is the procedure of choice as long as the condition of the remaining bowel is satisfactory.
Alam mengajari kebajikan bagi umat manusia. Alam merupakan suatu kesatuan, terdiri dari banyak ba... more Alam mengajari kebajikan bagi umat manusia. Alam merupakan suatu kesatuan, terdiri dari banyak bagian, seperti organisme dengan organ-organnya. Semua bagian berjalan dalam harmoni, saling melayani dan berbagi. Tiap organ memiliki peran masing-masing, saling melengkapi dan memberikan sinergi untuk menghasilkan keseimbangan secara optimal, dan berkelanjutan. Setiap komponen tidak berpikir dan beraksi hanya demi ‘aku’, tetapi untuk ‘kita’: keseluruhan alam. Demikian halnya Alam, melindungi dan mengayomi bagian-bagiannya secara harmonis. Itulah organis, tidak egois. Pertanian organik (PO) juga tunduk pada prinsip diatas, pada hukum alam. Segala yang ada di alam adalah berguna dan memiliki fungsi, saling melengkapi, melayani dan menghidupi untuk semua. Dalam alam ada keragaman hayati dan keseimbangan ekologi. Maka, PO pun menghargai keragaman hayati dan keseimbangan ekologi. Berjuta tahun alam membuktikan prinsipnya, tak ada eksploitasi selain optimalisasi pemanfaatan. Demikian halnya PO, tidak untuk memaksimalkan hasil, tidak berlebih; tetapi cukup untuk semua makhluk dan berkesinambungan. Inilah filosofi mendasar PO.
Objective: : Necrotizing enterocolitis (NEC) has become the most common gastrointestinal emergenc... more Objective: : Necrotizing enterocolitis (NEC) has become the most common gastrointestinal emergency among neonates and preterms admitted to the intensive care units. The aim of this study is to evaluate the surgical management of NEC as well as their outcome. Patients and methods: : Thirty five cases were included in this prospective study (10 full terms, 15 preterm and 10 infants) with the diagnosis of NEC. The severity of NEC episodes were determined according to Bells classification into group A (stage I 10 cases), Group B (stage II 17 cases) and group C (stage III 8 cases). Full history and clinical examination were taken. Radiological studies (abdominal plain X-ray and ultrasound), blood and stool cultures were done. Results: : All risk factors such as sepsis, hypoxia, premature rupture of membrane (PROM) and eclampsia were statistically significantly higher among group C than group A. The commonest presenting symptom was abdominal distension followed by vomiting. All positive radiological signs were statistically significantly higher among both groups B&C than group A except for pneumopritonium sign. Medical treatment was started and complete clinical improvement was achieved in all cases of group A and in 2 cases from group B. The remaining 23 cases (15 cases from group B and the 8 cases of group C) failed to respond to the medical treatment and were operated upon. Resection anastomosis was done for 12 cases from group B while resection with stoma formation was done for 3 cases from group B and 8 cases from group C. The over all mortality was 11 cases out of 35 (31.4%). 5 cases from group B and 6 cases from group C. Conclusions: : Early diagnosis and intensive medical and surgical treatment with laparotomy and resection of the affected bowel were mandatory to minimize both morbidity and mortality from NEC. Primary anastomosis is the procedure of choice as long as the condition of the remaining bowel is satisfactory.
Alam mengajari kebajikan bagi umat manusia. Alam merupakan suatu kesatuan, terdiri dari banyak ba... more Alam mengajari kebajikan bagi umat manusia. Alam merupakan suatu kesatuan, terdiri dari banyak bagian, seperti organisme dengan organ-organnya. Semua bagian berjalan dalam harmoni, saling melayani dan berbagi. Tiap organ memiliki peran masing-masing, saling melengkapi dan memberikan sinergi untuk menghasilkan keseimbangan secara optimal, dan berkelanjutan. Setiap komponen tidak berpikir dan beraksi hanya demi ‘aku’, tetapi untuk ‘kita’: keseluruhan alam. Demikian halnya Alam, melindungi dan mengayomi bagian-bagiannya secara harmonis. Itulah organis, tidak egois. Pertanian organik (PO) juga tunduk pada prinsip diatas, pada hukum alam. Segala yang ada di alam adalah berguna dan memiliki fungsi, saling melengkapi, melayani dan menghidupi untuk semua. Dalam alam ada keragaman hayati dan keseimbangan ekologi. Maka, PO pun menghargai keragaman hayati dan keseimbangan ekologi. Berjuta tahun alam membuktikan prinsipnya, tak ada eksploitasi selain optimalisasi pemanfaatan. Demikian halnya PO, tidak untuk memaksimalkan hasil, tidak berlebih; tetapi cukup untuk semua makhluk dan berkesinambungan. Inilah filosofi mendasar PO.
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