Necrotizing enterocolitis | |
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Radiograph of a baby with necrotizing enterocolitis | |
Specialty | Pediatrics, gastroenterology, neonatology |
Symptoms | Poor feeding, bloating, decreased activity, vomiting of bile |
Complications | Short-gut syndrome, intestinal strictures, developmental delay |
Causes | Unclear |
Risk factors | Preterm birth, congenital heart disease, birth asphyxia, exchange transfusion, prolonged rupture of membranes |
Differential diagnosis | Sepsis, anal fissure, infectious enterocolitis, Hirschsprung disease |
Prevention | Breast milk, probiotics. |
Treatment | Bowel rest, nasogastric tube, antibiotics, surgery |
Prognosis | Risk of death ~ 25% |
Classification |
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External resources |
Necrotizing enterocolitis (NEC) is a medical condition where a portion of the bowel dies. It typically occurs in newborns that are either premature or otherwise unwell. Symptoms may include poor feeding, bloating, decreased activity, blood in the stool, or vomiting of bile.
The exact cause is unclear. Risk factors include congenital heart disease, birth asphyxia, exchange transfusion, and prolonged rupture of membranes. The underlying mechanism is believed to involve a combination of poor blood flow and infection of the intestines. Diagnosis is based on symptoms and confirmed with medical imaging.
Prevention includes the use of breast milk and probiotics. Treatment includes bowel rest, oralgastric tube, intravenous fluids, and intravenous antibiotics. Surgery is required in those who have free air in the abdomen. A number of other supportive measures may also be required. Complications may include short-gut syndrome, intestinal strictures, or developmental delay.