| Necrotizing enterocolitis | |
|---|---|
 | |
| Radiograph of a baby with necrotizing enterocolitis | |
| Specialty | Pediatrics, gastroenterology, neonatology |
| Symptoms | Poor feeding, bloating, decreased activity, vomiting of bile[1] |
| Complications | Short-gut syndrome, intestinal strictures, developmental delay[2] |
| Causes | Unclear[1] |
| Risk factors | Preterm birth, congenital heart disease, birth asphyxia, exchange transfusion, prolonged rupture of membranes[1] |
| Differential diagnosis | Sepsis, anal fissure, infectious enterocolitis, Hirschsprung disease[2][3] |
| Prevention | Breast milk, probiotics.[2] |
| Treatment | Bowel rest, nasogastric tube, antibiotics, surgery[2] |
| Prognosis | Risk of death 25%[1] |
Necrotizing enterocolitis (NEC) is a medical condition where a portion of the bowel dies.[1] It typically occurs in newborns that are either premature or otherwise unwell.[1] Symptoms may include poor feeding, bloating, decreased activity, blood in the stool, or vomiting of bile.[1][2]
The exact cause is unclear.[1] Risk factors include congenital heart disease, birth asphyxia, exchange transfusion, and premature rupture of membranes.[1] The underlying mechanism is believed to involve a combination of poor blood flow and infection of the intestines.[2] Diagnosis is based on symptoms and confirmed with medical imaging.[1]
Prevention includes the use of breast milk and probiotics.[2] Treatment includes bowel rest, orogastric tube, intravenous fluids, and intravenous antibiotics.[2] Surgery is required in those who have free air in the abdomen.[2] A number of other supportive measures may also be required.[2] Complications may include short-gut syndrome, intestinal strictures, or developmental delay.[2]
About 7% of those that are born premature develop necrotizing enterocolitis.[2] Onset is typically in the first four weeks of life.[2] Among those affected, about 25% die.[1] The sexes are affected equally frequently.[4] The condition was first described between 1888 and 1891.[4]
References edit
- ^ a b c d e f g h i j k "Necrotizing Enterocolitis – Pediatrics – Merck Manuals Professional Edition". Merck Manuals Professional Edition. February 2017. Retrieved 12 December 2017.
- ^ a b c d e f g h i j k l m Rich, BS; Dolgin, SE (December 2017). "Necrotizing Enterocolitis". Pediatrics in Review. 38 (12): 552–559. doi:10.1542/pir.2017-0002. PMID 29196510. S2CID 39251333.
- ^ Crocetti, Michael; Barone, Michael A.; Oski, Frank A. (2004). Oski's Essential Pediatrics. Lippincott Williams & Wilkins. p. 59. ISBN 9780781737708.
- ^ a b Panigrahi, P (2006). "Necrotizing enterocolitis: a practical guide to its prevention and management". Paediatric Drugs. 8 (3): 151–65. doi:10.2165/00148581-200608030-00002. PMID 16774295. S2CID 29437889.