NECROTIZING ENTEROCOLITIS (NEC)
Last Updated : 1/12/2011
Ira Shah
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NEC

is a syndrome of acute intestinal necrosis. The etiology is unknown and pathogenesis is complex and multi factorial. It is the most common serious surgical disorder among infants in NICU & a significant cause of neonatal morbidity and mortality. It is seen in 2.5% of all NICU admissions and has an overall mortality rate of 30-40% with mortality increasing to more than 80% in neonates less than 1kg.

Predisposing factors
-

Prematurity

: Seen commonly at a mean gestational age of 30-32 wks. (AGA). It is the single greatest risk factor. Incidence of NEC increases as gestational age decreases.
- In Term infants & near terms : Conditions predisposing to decreased gastrointestinal oxygen delivery
- Perinatal asphyxia (lower 1 minute apgar score)
- Lower cord PH (acidosis)
- Polycythemia
- RDS / apnea
- Shock
- Umbilical artery catheterization
- Early / or large volume nasogastric feeding
- Congenital heart disease

Pathogenesis
- Role of immature Gastrointestinal host defenses
- Role of infectious agents & bacterial toxins
- Role of inflammatory mediators
- Role of oxygen radicals & ischemia reperfusion injury

Pathology
Common sites are terminal ileum and ascending colon.



Contributor Information and Disclosures

Ira Shah
Consultant Pediatrician, B.J.Wadia Hospital for Children, Mumbai, India


First Created : 1/7/2004

References

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