Necrotizing Enterocolitis

Signs and Symptoms

Symptoms of necrotizing enterocolitis (NEC) may include:

• Abdominal distension or swelling
• Signs of infection such as sluggishness and apnea, a condition in which a baby does not breath properly
• An unstable temperature
• Bloody stools
• Poor feeding
• Feeding intolerance
• Bile-colored, or green, gastric residuals or vomiting

Diagnosis

If the doctor suspects that your baby has necrotizing enterocolitis (NEC), an abdominal X-ray will be taken to look for signs of the condition.

Treatment

Treatment of necrotizing enterocolitis (NEC) depends on the severity of your baby's condition. Treatment may include surgery and medical therapy. This treatment plan may include:

• Stopping all regular feedings and using an intravenous (IV) catheter to provide nutrients to the baby.

• Placing a nasogastric tube extending from the baby's nose into their stomach. The tube suctions air and fluids from the baby's stomach and intestine.

• Antibiotic therapy to treat possible infections.

• Checking stools for blood.

• Frequent blood tests to look for signs of infection and imbalances in the body's chemistry.

• If abdominal swelling interferes with breathing, oxygen or mechanically assisted breathing is provided.

• In severe cases, platelet and red blood cell transfusion may be necessary.

Surgical Treatment

If a baby does not respond to medical treatment, or if there is a hole in the bowel, surgery is necessary. The pediatric surgeon will perform an abdominal laparotomy, a procedure that involves opening the abdomen, to examine the condition of the bowel. With severe NEC, part of the bowel may need to be removed. The goal is to remove only the part of the bowel that has no chance of recovery. In some cases, a rubber tube is placed in the abdomen to allow drainage of infected fluid.

A temporary ostomy, in which an opening is made in the wall of the abdomen, may be necessary to allow the bowel to recover and heal. Another operation to reexamine the abdomen may be required 24 to 48 hours later to determine if NEC has progressed.