Necrotizing enterocolitis (nec)

[Dianne]

Necrotizing enterocolitis is injury to the inner surface of the intestine. This disorder occurs most often in newborns who are premature and/or seriously ill.

The abdomen may be swollen, stools may be bloody, and the newborn may vomit a greenish, yellow, or rust-colored fluid and appear very sick and sluggish.
The diagnosis is confirmed by abdominal x-rays.
About 70 to 80% of newborns with this disorder survive.
Treatment involves stopping feedings, passing a suction tube into the stomach to remove stomach contents to relieve pressure, and giving antibiotics and fluids by vein (intravenously).
In severe cases, surgery is required to remove the damaged intestine.

Over 90% of cases of necrotizing enterocolitis occur in premature newborns. Necrotizing enterocolitis may occur in clusters or as outbreaks in neonatal intensive care units (NICUs). Sometimes these outbreaks can be linked to specific bacteria (such as E. coli), but often the cause is not known.
The cause of necrotizing enterocolitis is not completely understood, but it is in part related to immaturity of the intestine along with low oxygen levels in the blood and/or diminished blood flow to the intestine. Diminished blood flow to the intestine in a sick premature newborn may result in injury to the inner surface of the intestine. The injury allows bacteria that normally exist within the intestine to invade the damaged intestinal wall and then enter the newborn’s bloodstream, causing infection (sepsis). If the injury progresses through the entire thickness of the intestinal wall and the intestinal wall tears (perforates), intestinal contents leak into the abdominal cavity and cause inflammation and usually infection of the abdominal cavity and its lining (peritonitis).