Necrotizing enterocolitis (NEC) occurs in preterm, low-birth-weight infants and has an increasing incidence. Typically, it presents with lethargy, feeding intolerance, bloody stools, respiratory distress, hypoperfusion, and a tender/distended abdomen, whereas more advanced disease will demonstrate systemic symptoms. The Modified Bell’s Staging Criteria is often used to clinically and radiographically diagnose and stage NEC. Management begins with gastric decompression, stopping enteral nutrition, broad intravenous (IV) antibiotics, and correction of respiratory and metabolic derangements. If a patient meets criteria for surgical intervention and is >1500 g, then may proceed with laparotomy. If <1500 g and hemodynamically unstable, a percutaneous drain may be placed in the right lower quadrant to help stabilize the patient.
KeywordsNecrotizing enterocolitis (NEC) Preterm Low birth weight Feeding intolerance Pneumatosis intestinalis Portal venous gas Ischemic bowel Perforation Bell’s Staging Criteria Percutaneous drain
- 1.Castle SL, Speer AL, Grikscheit TC, Ford H. Necrotizing enterocolitis. In: Ziegler MM, Azizkhan RG, Dv A, Weber TR, editors. Operative pediatric surgery. New York: McGraw-Hill Education; 2014.Google Scholar