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Enterocolitis, Necrotizing

Synonyms

NEC

Definition and Characteristics

Necrotizing enterocolitis (NEC), characterized by intestinal necrosis (Fig. 1), typically presents with abdominal distension, occult or fresh blood in stools, and bilious emesis [1].
Enterocolitis, Necrotizing. Figure 1 A neonate with necrotizing enterocolitis. Note the necrotic bowel found at laparotomy.

Non-specific clinical features include lethargy, poor feeding, temperature instability, apnea, respiratory distress, and bradycardia [1]. Other manifestations such as abdominal wall erythema, abdominal tenderness and guarding, shock, metabolic acidosis, and disseminated intravascular coagulopathy are seen in severe cases.

Prevalence

NEC most commonly presents in the first 2 weeks of life [1]. The incidence is estimated to be 3 per 1,000 live births and 50 to100 per 1,000 in very low birthweight infants (<1,500 g) [2]. The male to female