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Shehzad Huda, Shabnum Chaudhery, Hassan Ibrahim, Arun Pramanik 

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Presentation on theme: "Shehzad Huda, Shabnum Chaudhery, Hassan Ibrahim, Arun Pramanik "— Presentation transcript:

1 Neonatal necrotizing enterocolitis: Clinical challenges, pathophysiology and management 
Shehzad Huda, Shabnum Chaudhery, Hassan Ibrahim, Arun Pramanik  Pathophysiology  Volume 21, Issue 1, Pages 3-12 (February 2014) DOI: /j.pathophys Copyright © Terms and Conditions

2 Fig. 1 Pathophysiological risk factors for necrotizing enterocolitis.
Pathophysiology  , 3-12DOI: ( /j.pathophys ) Copyright © Terms and Conditions

3 Fig. 2 X-rays KUB with markedly dilated sausage shaped loop (white arrow) and umbilical venous catheter in place. Pathophysiology  , 3-12DOI: ( /j.pathophys ) Copyright © Terms and Conditions

4 Fig. 3 X-rays KUB with black arrow depicts portal venous gas shadow and white arrow depicts pneumatosis intestinalis. Pathophysiology  , 3-12DOI: ( /j.pathophys ) Copyright © Terms and Conditions

5 Fig. 4 Football sign – black arrow depicts free air under the diaphragm and white arrow depicts falciform ligament. Pathophysiology  , 3-12DOI: ( /j.pathophys ) Copyright © Terms and Conditions

6 Fig. 5 Congested, discolored and thickened bowel due to edema and inflammation. Pathophysiology  , 3-12DOI: ( /j.pathophys ) Copyright © Terms and Conditions

7 Fig. 6 Dark, gray gangrenous bowel with hemorrhagic foci.
Pathophysiology  , 3-12DOI: ( /j.pathophys ) Copyright © Terms and Conditions

8 Fig. 7 (a) H&E-stained histological sections of a macroscopically unaffected segment, showing early signs of epithelial degeneration at villous tips and thrombus formation (arrow head) in an underlying vessel, hematoxylin–eosin stain, 100×. (b) Pathologic findings in NEC. Histologic sections of small bowel showing early stage of intestinal injury with hyperemia of mucosa and loss of epithelial cells at the villus tips (1). Intramural gas is seen as rounded bubbles in the submucosa (arrows), hematoxylin–eosin stain, 100×. (c) Here the bowel is affected much more severely. There is necrosis of the mucosa and submucosa with intraluminal necrotic debris on the mucosal side of the bowel wall (m) and loss of villi. The histologic characteristics of NEC include coagulative necrosis (1), bacterial overgrowth with inflammatory cell infiltration (2), mucosal edema and ulceration (3), hematoxylin–eosin stain, 100× with insert at 400×. (d) High magnification of a histological section of the necrotic small bowel mucosa showing characteristic vascular thrombi (arrowhead) and necrosis (arrow), hematoxylin–eosin stain, 200×. (e) Transmural necrosis of mucosa, submucosa, and muscularis propria extending to serosa with potential for perforation. s=serosal surface of bowel wall. Pathophysiology  , 3-12DOI: ( /j.pathophys ) Copyright © Terms and Conditions


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