Abstract
Excerpt: Feeding, gastrointestinal bacterial colonization, gut motility, cytokines, vascular factors, and gut blood flow all have been implicated in the etiology and pathogenesis of necrotizing entercolitis (NEC). Further, neonatal complications such as respiratory distress syndrome, respiratory disease, apnea, infection, hypotension, asphyxia, and patent ductus arteriosus increase the risk for development of NEC. Infants with NEC generally present with feeding intolerance, abdominal distension, bilious gastric residuals or vomiting, or bloody stools. Nonspecific presenting signs and symptoms include apnea, bradycardia, desaturation episodes, cyanosis, lethargy, temperature instability, poor peripheral perfusion, hypoglycemia, jaundice, and shock. Diagnosis of NEC is confirmed by the presence of the classic finding of pneumatosis intestinalis on abdominal x-ray. Associated laboratory abnormalities can include metabolic acidosis, leukopenia, thrombocytopenia, anemia, and clotting abnormalities of disseminated intravascular coagulation. Treatment consists of supportive medical care and surgical care.