Necrotizing Enterocolitis (NEC)

Ira Shah
Necrotizing Enterocolitis (NEC) - Introduction
NEC is a syndrome of acute intestinal necrosis. The etiology is unknown and pathogenesis is complex and multi factorial. It is the most common serious surgical disorder among infants in NICU & a significant cause of neonatal morbidity and mortality. It is seen in 2.5% of all NICU admissions and has an overall mortality rate of 30-40% with mortality increasing to more than 80% in neonates less than 1kg.

Common sites are terminal ileum and ascending colon.

- Prematurity: Seen commonly at a mean gestational age of 30-32 wks. (AGA). It is the single greatest risk factor. Incidence of NEC increases as gestational age decreases.
- In Term infants & near terms : Conditions predisposing to decreased gastrointestinal oxygen delivery
- Perinatal asphyxia (lower 1 minute apgar score)
- Lower cord PH (acidosis)
- Polycythemia
- RDS / apnea
- Shock
- Umbilical artery catheterization
- Early / or large volume nasogastric feeding
- Congenital heart disease

- Role of immature Gastrointestinal host defenses
- Role of infectious agents & bacterial toxins
- Role of inflammatory mediators
- Role of oxygen radicals & ischemia reperfusion injury

Necrotizing Enterocolitis (NEC) Necrotizing Enterocolitis (NEC) 01/07/2004
Clinical Staging Of NEC >>
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