Rectal involvement in necrotizing enterocolitis

Abstract

Although necrotizing enterocolitis (NEC) is a common cause of neonatal intestinal disease, rectal involvement has not previously been reported. We describe five children with NEC involving the rectum. In four infants pancolorectal disease occurred; in the fifth the ascending colon was spared. A Swenson-type abdomino-perineal resection was performed in four cases. No definitive cause for the extension of the disease into the distal rectum was noted. There were no immediate postoperative complications. Long-term follow-up showed normal anorectal function and a normal-appearing perineum. Possible rectal involvement should be considered in all neonates with colonic NEC. Contrast studies visualizing the rectum are advised prior to closing colostomies performed in newborns with NEC. Ileorectal anastomosis after resection produces a satisfactory result.