Necrotizing Enterocolitis

  • Jonathan H. DeAntonio
  • Dan W. Parrish
  • David A. LanningEmail author


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.


Necrotizing enterocolitis (NEC) Preterm Low birth weight Feeding intolerance Pneumatosis intestinalis Portal venous gas Ischemic bowel Perforation Bell’s Staging Criteria Percutaneous drain 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jonathan H. DeAntonio
    • 1
    • 2
  • Dan W. Parrish
    • 3
  • David A. Lanning
    • 1
    • 2
    • 4
    Email author
  1. 1.Division of Pediatric Surgery, Department of General SurgeryVirginia Commonwealth University HealthRichmondUSA
  2. 2.Department of SurgeryVirginia Commonwealth University School of MedicineRichmondUSA
  3. 3.Department of Pediatric Surgery, Batson Children’s HospitalUniversity of Mississippi Medical CenterJacksonUSA
  4. 4.Department of Surgery and PediatricsChildren’s Hospital of RichmondRichmondUSA

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