Routine contrast enemas for diagnosing and managing strictures following nonoperative treatment of XXXX .

@entity1 @entity3166 @entity1321
A study to determine the value of contrast enemas in diagnosing and managing intestinal strictures following nonoperative treatment of @entity3166 was performed from 1978 through 1983. From 1974 through 1977, 17 @entity1 survived nonoperative treatment of NEC and three developed symptomatic strictures, an incidence of 18% (3/17). Since then a total of 31 @entity1 were treated for NEC; three @entity1 survived operation for perforation and there were seven deaths, leaving 21 in the study group. Sixteen @entity1 had contrast enemas three to six weeks after resolution of NEC, which revealed strictures in five @entity1 . Four of the five @entity1 with strictures demonstrated on contrast enema were without obstructive symptoms. Three of the four remained asymptomatic without treatment, and one eventually required surgery for @entity1321 . The fifth @entity1 developed @entity1321 while still in the nursery and a contrast study demonstrated an ileal stricture. A sixth @entity1 had a normal contrast study and developed @entity1321 from an ileal stricture. The incidence of strictures was 38% (6/16). In five @entity1 , appointments for contrast studies were not kept, although clinical follow-up was complete in all. The incidence of symptomatic strictures for the contrast study period was therefore 14% (3/21). Although some authors have recommended routine contrast enemas in @entity1 surviving nonoperative treatment of NEC, contrast enemas had no advantage over clinical follow-up in the management of @entity1 in this study. We have discontinued the use of routine contrast enemas in favor of close follow-up and careful instruction to parents as to the early signs of @entity1321 .
