Curriculum · Pediatric / Nutrition & Growth / EPI / Routine Child Examination
Necrotising enterocolitis
What it is
Necrotizing enterocolitis is a hemorrhagic necrotizing inflammation of the intestinal wall. It is the most common cause of acute abdomen in premature infants. The peak incidence occurs between the 2nd and 4th week after birth, not during the first week, and it most commonly affects the distal ileum and proximal colon.
Causes and risk
The etiology listed is a defective or underdeveloped immune system and formula feeding. It is mainly in preterm infants, though the material notes that this is not necessary. It appears among the complications of preterm labour, alongside neonatal death, ARDS, intraventricular hemorrhage and cerebral palsy, and among the complications of PROM. In the prophylaxis given for PROM, Augmentin (Co-Amoxiclav) is avoided because it increases the risk of necrotizing enterocolitis.
How it presents
The clinical features listed are lethargy, a distended and shiny abdomen, gastric retention, vomiting, diarrhea and rectal bleeding. Feeding intolerance, abdominal distension, discoloration of the abdominal wall and septic behavior are also given.