PMID: 9181369May 1, 1997Paper

Histopathology and microbiology of isolated rectal bleeding in neonates: the so-called 'ecchymotic colitis'

Histopathology
D CanioniN Brousse

Abstract

Rectal bleeding in neonates is an alarming event which suggests a possible necrotizing enterocolitis (NEC) but is usually the only symptom of an unexplained colitis characterized endoscopically by ecchymotic mucosal lesions, the so-called 'ecchymotic colitis' (EC). We studied histologically and bacteriologically 18 infants (mean age: 18 days) presenting with rectal bleeding by systematic rectosigmoidoscopy and intestinal biopsies. The 18 infants were hospitalized. Prematurity was found in seven cases and an underlying condition in 14 cases (respiratory distress: six cases; infection: six cases; surgery: two cases). Histology showed a mild to moderate inflammation (10/12) of the mucosa with a prevalence of polymorphonuclear cells (8/10), frequent focal haemorrhages (11/12) and foci of pneumatosis (4/12). Numerous bacteria were seen in the mucus layer focally forming large clusters. Cultures of intestinal biopsies yielded exclusively Enterobacteriaceae species: Escherichia coli (seven cases), Klebsiella spp. (seven cases), and Enterobacter cloacae (three cases); four cases were sterile. Our study demonstrates that neonatal bleeding is associated with endoscopic and histological 'ecchymotic colitis' lesions and with a peculiar mic...Continue Reading

Citations

Dec 1, 2000·The Pediatric Infectious Disease Journal·W Rennert, C Ray
Aug 16, 2014·Early Human Development·Mohamed Ben SaidJean-Charles Picaud
Mar 30, 2005·Journal of Pediatric Gastroenterology and Nutrition·Christophe DupontPierre-Henri Benhamou
Jul 25, 2009·The Journal of Pediatrics·J Marc RhoadsMichael J Ferris
Jan 12, 2019·Pediatric Research·Thao T B HoAkhil Maheshwari

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