The Indian Journal of Pediatrics

, Volume 81, Issue 5, pp 489–497

Pathophysiology and Current Management of Necrotizing Enterocolitis


DOI: 10.1007/s12098-014-1388-5

Cite this article as:
Kasivajjula, H. & Maheshwari, A. Indian J Pediatr (2014) 81: 489. doi:10.1007/s12098-014-1388-5


Necrotizing enterocolitis (NEC), an inflammatory bowel necrosis of preterm infants, is the most common gastrointestinal emergency and a major cause of morbidity and mortality in these infants. In this article, the authors review the pathophysiology and clinical presentation of NEC and provide a critical appraisal of the evidence supporting various prophylactic and therapeutic strategies. A literature search was performed using the databases PubMed, EMBASE, and Scopus. Current pathophysiological models of NEC suggest that the disease occurs when mucosal injury in the preterm intestine results in translocation of luminal bacteria across the epithelial barrier, triggering an exaggerated and damaging local inflammatory response. Medical management of NEC is largely supportive and likely does not modify the etiopathogenesis of this disease. Antenatal steroids, human milk feedings, adoption of standardized feeding regimens, and probiotics hold promise for prevention of NEC. Future research should focus on early recognition that occurs well before the onset of intestinal necrosis, and prevention of this disease.



Copyright information

© Dr. K C Chaudhuri Foundation 2014

Authors and Affiliations

  1. 1.Division of Neonatology and the Center for Neonatal and Pediatric Gastrointestinal Disease, Department of PediatricsUniversity of Illinois at ChicagoChicagoUSA
  2. 2.Division of Neonatology, Center for Neonatal and Pediatric, Gastrointestinal DiseaseUniversity of IllinoisChicagoUSA