Necrotizing enterocolitis

Abstract

Necrotizing enterocolitis is a common and serous disease predominantly affecting premature newborns, with an incidence, morbidity, and mortality that has remained unchanged for several decades. Around 7% of infants between 500g and 1500g birth weight are affected, with the disease often manifesting with vomiting, bilious aspirates, distended abdomen, and blood in stools around 8–10 days of age. Medical management includes decompression of the gastrointestinal tract via a nasogastric tube, broad-spectrum antibiotics, and bowel ‘rest’ (total parenteral nutrition). Surgical intervention is required for intestinal perforation or ongoing deterioration despite medical management. The pathogenesis is multifactorial and includes genetic predisposition, gastrointestinal immaturity, imbalance in microvascular tone, abnormal intestinal microbiological colonization, and a highly immunoreactive intestinal mucosa. Breast milk feeds appear to confer some degree of protection.