Necrotizing Enterocolitis (NEC)

Ira Shah
Clinical Staging Of NEC

Stage Clinical features X-ray Survival (%)
  • Suspect NEC
  • Mild abdominal distension
  • Stasis
  • Vomiting
  • Poor feeding
  • Mild ileus

  • Definite NEC
  • Marked abdominal distension
  • GI bleeding
  • Definite ileus
  • Pneumatosis intestinalis

  • Advanced NEC
  • DIC
  • Shock
  • Sclerema
  • Brownish Peritoneal aspirate
  • Fixed dilated loop of intestine
  • Portal vein gas
  • Pneumoperitoneum


- Symptoms may appear within 96 hrs after initiation of feeds
- Majority of cases occur within first 10 days of life
- Onset may be insidious / explosive / delayed
- Earliest signs: abdominal distension, retention of milk in a sick-looking LBW infant.
- Clinical triad: Abdominal. Distension + GI bleeding + Pneumatosis intestinalis
- Signs of functional Intestinal obstruction: Abdominal distension, progressive decreased peristalsis, bilious vomiting, hematemesis and blood in stools
- Signs of peritonitis & perforation: Ascites, erythema & edema of abdominal wall, localized mass or rigidity
- Systemic signs respiratory distress, apnea, bradycardia, lethargy, thermal instability, irritability, poor feeding, hypotension (shock), oliguria, bleeding diathesis, sclerema

Necrotizing Enterocolitis (NEC) Necrotizing Enterocolitis (NEC) 01/07/2004
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