Intractable diarrhea in early infancy

Twenty infants with intractable diarrhea, whose onset was before 3 months of age, were analyzed. Twelve had identifiable pathological entities sufficient to explain their protracted diarrhea. A systematic diagnostic scheme for such babies is presented. Eight of the 20 infants had no identifiable cau...

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Bibliographic Details
Published in:Pediatrics (Evanston) 1968-04, Vol.41 (4), p.712-722
Main Authors: Avery, G B, Villavicencio, O, Lilly, J R, Randolph, J G
Format: Article
Language:English
Subjects:
Colostomy
Diarrhea, Infantile - etiology
Enterocolitis, Pseudomembranous - diagnosis
Enterocolitis, Pseudomembranous - pathology
Enterocolitis, Pseudomembranous - therapy
Humans
Infant
Infant, Newborn
Intestine, Small - pathology
Male
Steroids - therapeutic use
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Summary:Twenty infants with intractable diarrhea, whose onset was before 3 months of age, were analyzed. Twelve had identifiable pathological entities sufficient to explain their protracted diarrhea. A systematic diagnostic scheme for such babies is presented. Eight of the 20 infants had no identifiable cause for diarrhea of such severity and refractoriness, and these babies were termed non-specific enterocolitis. Six of these latter eight babies died and at autopsy had widespread enterocolitis with destruction of the mucosa and inflammatory infiltration. The authors believe that in these latter cases, regardless of the initial cause of the diarrhea, certain vicious cycles came into play which perpetuated the diarrhea. Preliminary evidence suggests that colostomy and, perhaps adrenal corticosteroids, may be useful in the therapy of refractory enterocolitis, particularly if applied before the terminal stages of the disease.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.41.4.712