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Necrotizing enterocolitis

Definition

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

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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