Necrotizing Enterocolitis (NEC)

Study Notes

Prematurity is the greatest risk factor for NEC, particularly in infants born before 32 weeks gestation.
Low birth weight, particularly under 1500 grams, is a significant contributor to the development of NEC.
Formula feeding instead of breast milk increases the risk of NEC in infants due to differences in gut flora and immune factors.
Infants with congenital heart disease or those receiving intensive medical care are at higher risk for developing NEC.

Abdominal distension or bloating is a common symptom, often leading to discomfort.
Feeding intolerance, characterized by vomiting or changes in stool pattern, is frequently noted in affected infants.
Lethargy and temperature instability may be observed, indicating systemic involvement.
Signs of septicemia, such as irritability or apnea, can also be present.

Intestinal perforation can occur, leading to peritonitis and requiring surgical intervention.
Short bowel syndrome may develop if extensive bowel resection is necessary.
Long-term complications include nutritional deficiencies and growth delays due to intestinal damage.
Increased risk of neurodevelopmental impairments has been associated with severe cases of NEC.

Alterations in gut microbiota due to antibiotic use may predispose infants to NEC.
Ischemia or reduced blood flow to the intestines can contribute to mucosal injury and subsequent NEC.
Early enteral feeding practices, particularly with formula, can trigger inflammatory responses in the gut.
Maternal factors, such as chorioamnionitis, can increase the risk of NEC in infants.

Radiological findings, particularly pneumatosis intestinalis (gas in the bowel wall), are key indicators for diagnosis.
Clinical signs such as abdominal tenderness and systemic signs of infection play a crucial role in diagnosis.
Laboratory tests revealing metabolic acidosis or elevated white blood cell counts can support the diagnosis of NEC.
Serial abdominal X-rays may be used to monitor progression or resolution of the condition.

Full-term infants typically have a lower risk of NEC, but conditions such as congenital anomalies can increase susceptibility.
Infants with critical illnesses or undergoing surgery may face heightened risks despite being full-term.
Maternal health issues, such as preeclampsia or diabetes, may predispose full-term infants to NEC.
Birth asphyxia and related complications may also elevate the risk for NEC in otherwise healthy full-term infants.