Necrotizing Enterocolitis: A dreadful condition of premature babies

Document Type: Case Report

Author

Fernandez Hospital ,ooposite OLD MLA quarters

Abstract

NEC is inflammatory necrosis of intestine with most common site being terminal ileum and ascending colon in preterm babies (1). The condition is typically seen in premature infants, and the timing of its onset is generally inversely proportional to the gestational age of the baby at birth, i.e. The earlier a baby is born, longer is the time of risk for NEC in premature babies. The incidence of NEC is inversely proportional to the gestational age and birth weight (2). Baby have initial symptoms which include feeding intolerance, increased gastric residuals, abdominal distension and bloody stools (3). The laboratory triad includes metabolic acidosis, hyponatremia and thrombocytopenia. Pneumatosis intestinalis is the pathognomonic radiological finding in the NEC. Modified Bell’s staging is used to stage the NEC. Treatment involves Nil per Oral, supportive care, antibiotics, surgery in advanced stages and parenteral nutrition (4,5). Complication of NEC includes mortality, prolonged NICU stay, intestinal strictures, enterocutaneous fistula, intra-abdominal abscess, cholestasis, and short-bowel syndrome (6,7), neurodevelopmental, motor, sensory, and cognitive problems (8,9).

Keywords


  1. Kliegman RM, Hack M, Jones P,  Fanaroff AA. Epidemiological study of necrotizing enterocolitis among low birth weight infants. J Pediatr. 1982; 100(3): 440–4.
  2. Mizrahi A, Barlow O, Berdon W, et al. Necrotizing enterocolitis in premature infants. J Pediatr. 1965; 66(4): 697–705.
  3. Touloukian RJ. Neonatal enterocolitis: an update on etiology, diagnosis, and treatment. Surg Clin North Am. 1976; 56(2): 281–98.
  4. Sántulli TVSchullinger JNHeird WCGongaware RDWigger JBarlow B, et al. Acute necrotizing enterocolitis in infancy: a review of 64 cases. Pediatrics. 1975;55(3):376–87
  5. Kanto WP Jr, Hunter JE, Stoll BJ. Recognition and medical management of necrotizing enterocolitis. Clin Perinatol. 1994; 21(2):335–46
  6. Abdullah FZhang YCamp MMukherjee DGabre-Kidan AColombani PM, et al. Necrotizing enterocolitis in 20,822 infants:analysis of medical and surgical treatments. Clin Pediatr (Phila) 2010; 49(2):166–71.
  7. Guner YSFriedlich PWee CPDorey FCamerini VUpperman JS.. State-based analysis of necrotizing enterocolitis outcomes. J Surg Res. 2009; 157(1):21–9.
  8. Martin CRDammann OAllred ENPatel SO'Shea TMKuban KC, et al. Neurodevelopment of extremely preterm infants who had necrotizing enterocolitis with or without late bacteremia. J Pediatr. 2010; 157(5):751–756.e1.
  9. Shah DKDoyle LWAnderson PJBear MDaley AJHunt RW, et al. Adverse neurodevelopment in preterm infants with postnatal sepsis or necrotizing enterocolitis is mediated by white matter abnormalities on magnetic resonance imaging at term. J Pediatr. 2008; 153(2):170–5, 175.e1.