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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Necrotizing enterocolitis

Last reviewed: May 21, 2013.

Necrotizing enterocolitis is the death of tissue in the intestine. It occurs most often in premature or sick babies.

Causes

Necrotizing enterocolitis occurs when the lining of the intestinal wall dies and the tissue falls off. The exact cause of this disorder is unknown. It is thought, however, that a drop in blood flow to the bowel keeps the bowel from producing mucus. The mucus protects the gastrointestinal tract. Bacteria in the intestine may also be a cause.

Most of the time, this problem develops in an infant that is ill or premature. It is likely to occur while the infant is still in the hospital.

Babies at higher risk of the condition include:

  • Premature infants
  • Infants who are fed concentrated formulas
  • Infants in a nursery where an outbreak has occurred
  • Infants who have received blood exchange transfusions

Symptoms

Symptoms may come on slowly or suddenly, and may include:

Exams and Tests

Treatment

Treatment for a baby that may have necrotizing entercolis include:

  • Halting regular feedings
  • Relieving gas in the bowel by inserting a tube in the stomach
  • Giving IV fluids and antibiotic medicines
  • Monitoring the condition with abdominal x-rays, blood tests, and measurement of blood gases

The infant will need surgery if there is a hole in the intestines or inflammation of the abdominal wall (peritonitis).

In this surgery, the doctor will:

The bowel is reconnected after several weeks or months when the infection has healed

Outlook (Prognosis)

Necrotizing enterocolitis is a serious disease. About 1 in 4 infants die from it. Early, aggressive treatment helps improve the outcome.

Possible Complications

When to Contact a Medical Professional

Get emergency medical care if any symptoms of necrotizing enterocolitis develop. Infants that have been hospitalized for illness or prematurity are at higher risk and should be watched for this problem.

References

  1. Maheshwari A, Waldemar AC. Digestive system disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 96.

Review Date: 5/21/2013.

Reviewed by: Todd Eisner, MD, Private practice specializing in Gastroenterology, Boca Raton, FL. Clinical Instructor, Florida Atlantic University School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Antibiotic usage for necrotising enterocolitis in newborn infantsAntibiotic usage for necrotising enterocolitis in newborn infants
    Necrotising enterocolitis (NEC) is a gastrointestinal disease that primarily affects premature infants. Infants who have developed NEC could rapidly become very sick, leading to various morbidities and even death. The cause of NEC is uncertain and possibly multifactorial, but an infectious agent is most commonly suspected. Various antibiotic combinations are commonly used as treatment in such infants. Certain antibiotic regimens could lead to drug side effects and even antibiotic resistance. The authors of this study reviewed the medical literature to ascertain the best antibiotic combination for the treatment of this condition. Four eligible studies were identified and only two of these studies were found to be suitable for analysis. Both these studies were performed before 1988. The two studies included 62 infants with NEC and compared one antibiotic regimen to another. There was no difference between the two groups. The authors concluded that there was insufficient evidence to recommend a particular antibiotic regimen for NEC.
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Figures

  • Infant intestines.

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