Necrotizing enterocolitis

Abstract

1) Necrotizing enterocolitis (NEC) is the most common emergency encountered by pediatric surgeons in the neonatal intensive care unit (NICU). It is an acquired inflammatory disease affecting the immature gastrointestinal tract of premature infants. 2) NEC is multifactorial and incompletely understood but classically occurs after an insult results in mucosal compromise of the gut barrier in infants receiving enteral feeds that leads to an exaggerated immune response that can ultimately result in intestinal necrosis. 3) Although management is initially supportive with fluid resuscitation, gastric decompression, broad spectrum antibiotics, and total parenteral nutrition, up to 50% of infants will require operative intervention in the acute stage. 4) There is ongoing debate regarding whether peritoneal drainage (PD) or laparotomy is the treatment of choice for perforated NEC in extremely low-birth-weight neonates.