Necrotizing Enterocolitis
Necrotizing enterocolitis is the pre-eminent gastrointestinal disease in the neonatal intensive care unit. The high-risk premature infants has 5-15% chance of developing this condition and the theories related to the cause are:
– gastrointestinal ischemia
– underdevelopment of gastrointestinal immune protection
– infectious agents
– and enteral alimentation.
Clinically, the neonate has a history of neonatal anoxia following delivery or umbilical catherization for exchange transfusion.
The infants will present with:
– abdominal distention
– vomiting
– diarrhea usually bloody and mucoid in nature
– gastric retention
– temperature instability
– bradycardia
– and apnea
The diagnosis of necrotizing enterocolitis (NEC) is confirmed by roentgenographic examination. On radiography, there will be seen a generalized distension of the intestines with one or more loops to be more dilated than the rest. There will also be seen intramural gas that appear as small bubbly or linear intramural collection of air usually in the right lower quadrant of the abdomen which is usually the common site being involved. Free air or pneumoperitoneum will indicate an intestinal perforation. The presence of gas in the portal vein as a result of portal gas flow towards the liver is a bad sign. So, NEC is a life- threatening condition among the infants in the neonatal intensive care unit and for this reason, the neonatologist are always on the look out for its earliest signs.
