Necrotizing Enterocolitis

  • Cynthia A. Gingalewski


Necrotizing enterocolitis (NEC) is the most common diagnosis that requires emergent operation in the neonate. Since first described by Touloukian in 1966, the pathophysiology of this disease remains an enigma. The disease involves the culmination of three factors: a premature infant, an immature immune system, and a gastrointestinal tract colonized with pathologic bacteria (Fig. 49.1). When these three factors are present in the setting of feeding an immature intestinal tract, an unknown trigger or series of events occur that together create the “perfect storm” that is NEC.


Premature Infant Short Bowel Syndrome Necrotizing Enterocolitis Peritoneal Drainage Intestinal Stricture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

  1. Ein SH, Marshall DG, Girvan D. Peritoneal drainage under local anesthesia for perforation from necrotizing enterocolitis. J Pediatr Surg. 1977;12:963–7.CrossRefPubMedGoogle Scholar
  2. Gribar SC, Richardson WM, Sodhi CP, et al. No longer an innocent bystander: epithelial toll-like receptors signaling in the development of mucosal inflammation. Mol Med. 2008;14(9–10):645–59.PubMedGoogle Scholar
  3. Ishihara S, Rumi MA, Ortega-Cava CF, et al. Therapeutic targeting of toll-like receptors in gastrointestinal inflammation. Curr Pharm Des. 2006;12(32):4215–28.CrossRefPubMedGoogle Scholar
  4. Lin HC, Hsu CH, Chen HL, et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial. Pediatrics. 2008;122(4):693–700.CrossRefPubMedGoogle Scholar
  5. Moss RL, Dimmit RA, Barnhart DC, et al. Laparotomy versus peritoneal drain for necrotizing enterocolitis and perforation. N Engl J Med. 2006;354(21):2225–34.CrossRefPubMedGoogle Scholar
  6. Salhab WA, Perlman JM, Silver L, et al. Necrotizing enterocolitis and neurodevelopmental outcome in extremely low birth weight infants <1000 g. J Perinatol. 2004;24:534–40.CrossRefPubMedGoogle Scholar
  7. Touloukian RJ. Ischemic gastroenterocolitis in infants:clinical aspects and thoughts on its etiology. Conn Med. 1973;37(5):229–34.PubMedGoogle Scholar
  8. Touloukian RJ, Smith GJ. Normal intestinal length in preterm infants. J Pediatr Surg. 1983;18(6):720–3.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of General SurgeryGeorge Washington University, Children’s National Medical CenterWashingtonUSA

Personalised recommendations