NEC Necrotizing enterocolitis By: Maria Castanon

What does it mean? Necrotizing= the death of tissues entero= small intestine colo= the large intestine itis= inflammation Necrotizing enterocolitis (NEC) is a disease that affects mostly the intestine of premature infants. The wall of the intestine is invaded by bacteria, which cause local infection and inflammation that can destroy the wall of the bowel (intestine).

History of NEC In The Beginning NEC was first described in 1950’s and later became recognized clinically in the 1960’s and 1970’s. It was first well-characterized in Prior to that year, it almost did not exist. In 1964 in New York 21 cases of True NEC had been reported. It was not until respiratory support was adequate to save premature children with immature lungs that the disease became clinically important.

The exact cause of NEC condition are still idiopathic (unknown). However, it’s believed that a lack of oxygen during a difficult delivery may be a contributing factor. When there’s reduced oxygen or blood flow to the intestine, it can become weak. This makes it easier for bacteria from food to enter the intestine and cause damage to the intestinal tissues. This can lead to development of an infection or NEC. Premature babies often have underdeveloped body systems. This may cause them to have difficulty with digestion, fighting infection, and blood and oxygen circulation. This is one of the most common GI emergency in newborns.

Sign and Symptoms Include: swelling or bloating of the abdomen discoloration of the abdomen bloody stool diarrhea poor feeding vomiting symptoms of an infection include: apnea, or disrupted breathing fever lethargy The condition can become life-threatening if it’s not treated.

A doctor can do a physical examination which include: gently touch the baby’s abdomen to check for swelling, pain, and tenderness. They’ll then perform an abdominal X-ray. The X-ray can show signs of inflammation. The stool can also be tested to look for the presence of blood. This is called a stool guaiac test. Certain blood tests are needed to measure the platelet levels and white blood cell counts. Low platelet levels or a high white blood cell count can be a sign of NEC. Inserting a needle into the baby’s abdominal cavity to check for fluid in the intestine may be needed. The presence of intestinal fluid usually means there’s a hole in the intestine. How can it be diagnosed?

Treatment Stop feeding and baby will receive their fluids and nutrients intravenously or through an IV. Antibiotics to help fight infection. If difficulty breathing due to a swollen abdomen, they’ll receive extra oxygen or breathing assistance. Sometimes depending on the severity, surgery may be needed and the procedure may be removal of the damaged sections of the intestines. The mortality rate is 20 to 35%. Aggressive support and surgical intervention may maximize the chance of survival. Most babies recover without complications once they are treated.

Prevention of NEC still remains unknown, but things that can minimize NEC include: Avoidance of preterm births use of antenatal steroids breast-milk feeding These are practices that offer the greatest potential benefits until further research.