Rezumat Aspecte clinice æi chirurgicale în enterocolita ulceronecroticã Scopul lucrãrii este acela de a stabili dacã parametrii clinici şi radiologici pot determina prognosticul şi progresia patologiei, necesitatea realizãrii laparotomiei sau a drenajului peritoneal, precum şi mortalitatea în rândul pacienåilor trataåi chirurgical. Un numãr de 51 de pacienåi diagnosticaåi cu enterocolitã ulceronecroticã internaåi în clinica de chirurgie a Spitalului de Urgenåã pentru Copii “Grigore Alexandrescu” în perioada 2005-20011 au fost evaluaåi, fiind adunate informaåii cu privire la examenul clinic şi radiologic. Mortalitatea în rândul pacienåilor trataåi chirurgical este de 59.9%. Toåi pacienåii diagnosticaåi cu enterocolitã stagiul III au fost supuşi unei intervenåii chirurgicale, mortalitatea în rândul acestora fiind crescutã. S-a constat cã pentru pacienåilor la care simptoma- tologia a debutat mai târziu, patologia a fost mai severã şi prognosticul vital al acestor copii a fost unul prost. Cuvinte cheie: stadializare Bell, debutul simptomatologiei, examen radiologic Abstract Background: The purpose of the paper is to establish whether clinical and radiological parameters can predict the progression of the pathology, the necessity of performing laparotomy for patients with peritoneal drain and the mortality in surgically treated neonatal necrotizing enterocolitis patients. Material and Methods: A number of 51 cases with necrotizing enterocolitis from our institution were reviewed (from 2005 to 2011) and information on patient demographics and data about the clinical and radiological parameters was collected. Results: Of the 51 patients, 29 were (56.8%) males and 22 (43.2%) females. Age at presentation ranges between 1 and 87 days, with a mean 18.71 days. Birth weight varies between 400- 4700g (mean 1979.6 g ± 1012.5). The mortality rate in our study was 45% (23 patients out of 51). Conclusions: The mortality rate in our series was 45%. Even though Bell stage III patients have clear indications for surgery, the procedure involves high fatality. Patients who undergo surgery are more likely to die than the ones who do not. We found that a later debut of symptoms should be an alarm sign for both the severity of the condition and for its outcome. Key words: Bell’s stage, neonatal enterocolitis, debut symptoms, radiological findings Introduction Introduction Necrotizing enterocolitis (NEC) is one of the most common surgical emergencies in newborns, with a mortality rate that exceeds that of any other gastrointestinal condition that requires surgical repair (1). NEC diagnosis requires a combina- tion of clinical, laboratory and radiological findings, which were divided into systemic, abdominal and radiological signs by Walsh et al by modifying Bell’s original staging criteria (2). Clinical and Surgical Aspects in Necrotizing Enterocolitis R.N. Bãlãnescu, L. Topor, G.C. Drãgan Department of Pediatric Surgery, “Grigore Alexandrescu” Emergency Clinical Hospital for Children, Bucharest, Romania Chirurgia (2013) 108: 184-188 No. 2, March - April Copyright© Celsius Corresponding author: Laura Topor, MD Vaporul lui Assan Street, no. 4, Bucharest Romania E-mail: lauratopor@yahoo.com