Non-specific Necrotizing Jejunitis: A New Challenging Entity.

Abstract

Non-specific Necrotizing Jejunitis (NNJ) is an uncommon paediatric surgical problem. Nine cases of NNJ presenting as acute abdomen were studied. Exploration revealed ischemic changes in small intestine especially in jenunum varying from punctate haemorrhagic spots in seromuscular is to generalized dusky areas of impending perforation. In 2 cases ileum was also involved along with jejunum. Histopathological examination of enlarged mesenteric lymph nodes and resected segment of gangrenous gut showed non-specific changes. Simple exploration of abdomen and mesenteric lymph node biopsy was performed in 7 cases, where as in 2 cases of impending perforation resection and anastomosis had to be done. Culture of peritoneal fluid was inconclusive. Hospital stay was shorter in cases undergoing resection and anastomosis than those having simple exploration. The pathology appears to be a kind of local hyper immune reaction provoked by endotoxins in the segment of bowel involved. It is the first series of NNJ ever reported in Pakistan. Clinicians are encouraged to be aware of this unusual entity.