Nectotizing enterocolitis: is there a place for resection and primary anatomosis?

While most situations of peritonitis, perforation and compromised blood flow in necrotizing enterocolitis are best handled by resection and stoma formation, primary resection and anastomosis should be considered in selected cases. Nine premature infants with NEC underwent bowel resection with primary anastomosis in the face of localized perforation and peritonitis. Eight survived and had no problems when oral alimentation was started. One patient with small bowel involvement underwent two anastomoses rather than a high jejunostomy; the proximal anastomosis leaked and led to the death of the patient.