Differentiating Clinical Characteristics Between Necrotizing Enterocolitis and Food Protein-induced Enterocolitis When Both have Pneumatosis Intestinalis: A Single-centre Study.

Abstract

To compare the clinicalcharacteristics of necrotizing enterocolitis (NEC) and food protein-induced enterocolitis (FPIES) when both have pneumatosis intestinalis (PI) and to identify them. Analytical study. Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, China, from January to December 2019. Medical data of neonates, who were diagnosed with NEC (Bell's Stage ≥2a) or FPIES, were retrospectively evaluated. All included infants had abdominal radiographic PI positive. According to the infants' diagnoses, they were classified into groups NEC and FPIES. The clinical characteristics of NEC and FPIES were compared to find the differences. A totalof293 infants were included,ofwhich 205 were diagnosed with NEC andother 88were FPIES. NEC was characterised by low birth weight (BW), gestational age (GA) and onset time; NEC had higher rates of mother's antenatal steroid therapy, formula feeding, sepsis, and anemia. NEC and FPIES both had a set ofsimilarsignsandsymptomswhich varied depending on the severity of the disease, except for abdominal tenderness and absent bowel sounds only observed in NEC. The rates of continuous elevated C-reactive protein (CRP) and thrombocytopenia were also higher in NEC than in FPIES (p<0.05). When PI-positive, although infants diagnosed with NEC or FPIES lack specificsignsandsymptoms, there are still clinicalcharacteristics that need to be focused on: risk factors (BW, GA, onset time, mother's antenatal steroid therapy, formula feeding, sepsis, and anemia), abdominal signs (abdominal tenderness and absent bowel sounds), the results of CRP and platelet, which may help clinicians to identify them. Necrotizing enterocolitis, Food protein-induced enterocolitis syndrome, Pneumatosis intestinalis, Neonate.