{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:13:54Z","timestamp":1784762034264,"version":"3.55.0"},"reference-count":8,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,5,25]]},"abstract":"<jats:p>A 7-year-old boy presented in septic shock secondary to appendicitis with generalised peritonitis. Following crystalloid resuscitation, he underwent surgery. Faecopurulent contamination and free air were found. This was secondary to a perforated and gangrenous appendix, multiple large and small bowel segments with perforations, patches of necrosis, interspersed with healthy bowel and segments of questionable viability. There was also a perforated duodenal ulcer. Necrotic segments were resected using a \u2018clip-and-drop\u2019 technique to shorten operative duration and guide resection to preserve bowel length. After six laparotomies and multiple bowel resections, the child was discharged home with an ileostomy that was subsequently reversed. He is currently on a normal diet and pursuing all activities appropriate for his age. Perforated appendicitis can be associated with widespread bowel necrosis and multiple perforations. A conservative damage limitation approach using the \u2018clip-and-drop\u2019 technique and relook laparotomies is useful in the management of extensive bowel necrosis in children.<\/jats:p>","DOI":"10.1136\/bcr-2015-209808","type":"journal-article","created":{"date-parts":[[2015,6,8]],"date-time":"2015-06-08T06:59:36Z","timestamp":1433746776000},"page":"bcr2015209808","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Management of necrotising appendicitis associated with widespread necrotising enterocolitis of the small and large bowel and perforated duodenal ulcer"],"prefix":"10.1136","volume":"2015","author":[{"given":"Vaibhav","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Toronto, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto","family":"Zani","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, QMC, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shailinder","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, QMC, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,6,8]]},"reference":[{"key":"2025082722245406000_2015.jun08_1.bcr2015209808.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38940.664363.AE"},{"key":"2025082722245406000_2015.jun08_1.bcr2015209808.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2012.12.008"},{"key":"2025082722245406000_2015.jun08_1.bcr2015209808.3","first-page":"39","article-title":"The pathogenesis of pig-bel in Papua New Guinea. 1979","volume":"48","author":"Lawrence","year":"2005","journal-title":"P N G Med J"},{"key":"2025082722245406000_2015.jun08_1.bcr2015209808.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(96)90492-3"},{"key":"2025082722245406000_2015.jun08_1.bcr2015209808.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2008.09.031"},{"key":"2025082722245406000_2015.jun08_1.bcr2015209808.6","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1291287"},{"key":"2025082722245406000_2015.jun08_1.bcr2015209808.7","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1055\/s-0034-1387942","article-title":"International survey on the management of necrotizing enterocolitis","volume":"25","author":"Zani","year":"2015","journal-title":"Eur J Pediatr Surg"},{"key":"2025082722245406000_2015.jun08_1.bcr2015209808.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-004-1268-6"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2015-209808","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:25:02Z","timestamp":1756358702000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2015-209808"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,8]]},"references-count":8,"alternative-id":["10.1136\/bcr-2015-209808"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2015-209808","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6,8]]}}}