Necrotizing Enterocolitis (NEC) is a serious disease that primarily affects a baby's gastrointestinal tract, which consists of the mouth, stomach, small intestine, large intestine and anus. Although the exact cause of necrotizing enterocolitis (NEC) is still unknown, it can be further associated with an infection.
Damage caused by necrotizing enterocolitis (NEC) to the intestines may create a hole in the intestines, allowing bacteria normally present in the intestines to leak out into the abdomen and cause infection. Even with treatment, this can cause serious complications.
In more severe cases, it may be necessary to surgically extract part of the intestine. In the most severe cases, necrotizing enterocolitis (NEC) can be fatal.
The vast majority of necrotizing enterocolitis (NEC) cases is found in very premature infants. Even so, the condition only affects a small percentage of premature infants.
However, necrotizing enterocolitis (NEC) is rare because of their increased risk premature infants are monitored closely during feedings.
Diagnosis of Necrotizing Enterocolitis
If the doctor founds that your baby has necrotizing enterocolitis, an abdominal X-ray will be performed to look for signs of the condition.
Signs & Symptoms of Necrotizing Enterocolitis
Symptoms of necrotizing enterocolitis may include:
- Abdominal distension or swelling in almost all cases (although most infants with abdominal distension don't have NEC)
- An unstable temperature
- Bloody stools
- Poor feeding
- Feeding intolerance
- Bile-colored, or green, gastric residuals or vomiting
Treatment of Necrotizing Enterocolitis
Treatment of necrotizing enterocolitis relies on the severity of the baby's condition. The treatment plan can include medical treatments or surgery.
Medical treatments may include:
- all regular feedings should be stopped and an intravenous (IV) catheter should be used to provide nutrients to the baby
- A nasogastric tube should be placed extending from the baby's nose into the stomach to suction air and fluids from the baby's stomach and intestine
- Antibiotic therapy to treat possible infections
- Checking stools for blood
- Regular blood tests to identify signs of infection and imbalances in the body's chemistry
- if abdominal swelling interferes with breathing, oxygen or mechanically assisted breathing
- In major cases, platelet and red blood cell transfusion
If a baby doesn't respond to medical treatment, or if there's a hole in the intestines, surgery is necessary. The doctor would like to perform an abdominal laparotomy, a procedure that involves opening the abdomen to examine the condition of the bowel.
With major necrotizing enterocolitis, part of the bowel may be extracted. The goal is to remove only the part of the bowel that has no chance of recovery. In some of the 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.
As part of the procedure, a stoma is created to allow the passage of stool. Another operation can be performed to reexamine the abdomen 24 to 48 hours later to determine if necrotizing enterocolitis has progressed or not.