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Necrotizing enterocolitis

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birthday. The NEC Society is a patient-led organization that collaborates with expert clinicians and researchers to better understand, prevent, and treat this devastating neonatal intestinal disease. Today, patient-families and experts from around the world work together to improve outcomes for the most vulnerable infants at risk of NEC. Their work and numerous initiatives combine the patient-family perspective with solutions based on the best available scientific evidence.
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review in 2020 (updated in 2023) found low- to moderate-quality evidence that supplementation of probiotics enterally "prevents severe NEC, as well as all-cause mortality in preterm infants" but cautioned that the evidence was not sufficient to inform policy and practice and that further high-quality
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or donor can be used if mother's milk is unavailable. The gut mucosal cells do not get enough nourishment from arterial blood supply to stay healthy, especially in very premature infants, where the blood supply is limited due to immature development of the capillaries, so nutrients from the lumen of
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Towards understanding intervention with human milk, experts have noted cow's and human milk differ in their immunoglobular and glycan compositions. Due to their relative ease of production, human milk oligosaccharides (HMO) are a subject of particular interest in supplementation and intervention.
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Meta-analyses of four randomized clinical trials performed over the period 1983 to 2005 support the conclusion that feeding preterm infants human milk is associated with a significant reduction (58%) in the incidence of NEC. A more recent study of preterm infants fed an exclusive human milk diet
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When NEC is diagnosed and treated immediately, the prognosis for babies is generally very good. Most babies recover fully without any additional health problems. Overall, about 70-80% of infants who develop NEC survive. Medical management of NEC shows an increased chance of survival compared to
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has proven to be useful, as it may detect signs and complications of NEC before they are evident on radiographs, specifically in cases that involve a paucity of bowel gas, a gasless abdomen, or a sentinel loop. Diagnosis is ultimately made in 5–10% of very-low-birth-weight infants (<1,500g).
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is a 501(c)(3), non-profit organization dedicated to building a world without necrotizing enterocolitis (NEC) through research, advocacy, and education. The NEC Society was launched in January 2014 by Jennifer Canvasser after her son, Micah, died from complications of NEC just before his first
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surgical management. Despite a significant mortality risk, long-term prognosis for infants undergoing NEC surgery is improving, with survival rates of 70–80%. However, "Surgical NEC" survivors are still at risk for possible long-term complications, such as narrowing of the intestines or
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If a baby is diagnosed with NEC, treatment should begin immediately. Treatment consists primarily of supportive care, including providing bowel rest by stopping enteral feeds, gastric decompression with intermittent suction, fluid repletion to correct electrolyte abnormalities and
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Typical recovery from NEC if medical, nonsurgical treatment succeeds, includes 10–14 days or more without oral intake, and then demonstrated ability to resume feedings and gain weight. Recovery from NEC alone may be compromised by co-morbid conditions that frequently accompany
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Uauy RD, Fanaroff AA, Korones SB, Phillips EA, Phillips JB, Wright LL. Necrotizing enterocolitis in very low birth weight infants: biodemographic and clinical corre-lates. National Institute of Child Health and Human Development Neonatal Research Network. J Pediatr.
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volumes at lower rates does not appear to reduce the risk of NEC or death in very preterm infants and seems to increase the risk of invasive infection. Not beginning feeding an infant by mouth for more than 4 days does not appear to have protective benefits.
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The condition is typically seen in premature infants, and the timing of its onset is generally inversely proportional to the gestational age of the baby at birth (i.e., the earlier a baby is born, the later signs of NEC are typically seen).
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Small amounts of oral feeds of human milk starting as soon as possible, while the infant is being primarily fed intravenously, primes the immature gut to mature and become ready to receive greater intake by mouth. Human milk from a
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In the United States, NEC caused 355 deaths per 100,000 live births in 2013, down from 484 per 100,000 live births in 2009. Rates of death were almost three times higher for the black population than for the white population.
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Muchantef K, Epelman M, Darge K, Kirpalani H, Laje P, Anupindi SA. Sonographic and radiographic imaging features of the neonate with necrotizing enterocolitis: correlating findings with outcomes. Pediatr Radiol. 2013 Jun
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they are placed in. Onset is typically in the first four weeks of life. Among those affected, about 25% die. The sexes are affected with equal frequency. The condition was first described between 1888 and 1891.
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As an infant recovers from NEC, feeds are gradually introduced. "Trophic feeds" or low-volume feeds (<20 ml/kg/day) are usually initiated first. How and what to feed are determined by the extent of
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Gephart SM, Spitzer AR, Effken JA, Dodd E, Halpern M, McGrath JM. Discrimination of GutCheckNEC: a clinical risk index for necrotizing enterocolitis. J Perinatol. 2014;34(6):468-475.
2442: 753:, immediate emergency surgery to resect the dead bowel is generally required, although abdominal drains may be placed in very unstable infants as a temporizing measure. Surgery may require a 543:, which can show the intestines and may show areas with dead tissue or a bowel perforation. Specific radiographic signs of NEC are associated with specific Bell's stages of the disease: 2435: 1863:
Boix-AmorĂłs A, Collado MC, Van't Land B, Calvert A, Le Doare K, Garssen J, et al. (May 2019). "Reviewing the evidence on breast milk composition and immunological outcomes".
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Palleri E, Aghamn I, Bexelius TS, Bartocci M, Wester T (September 2018). "The effect of gestational age on clinical and radiological presentation of necrotizing enterocolitis".
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The NEC Society hosts an in-person, biennial Symposium where clinicians, scientists and patient-families come together to listen, learn and collaborate. It is held as an “
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Diagnosis of NEC is more challenging in premature infants, due to inexplicit symptoms and radiographic signs. The most preterm infant is at highest risk of developing NEC.
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Downard CD, Grant SN, Maki AC, Krupski MC, Matheson PJ, Bendon RW, et al. (July 2012). "Maternal cigarette smoking and the development of necrotizing enterocolitis".
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Horbar JD, Edwards EM, Greenberg LT, et al. Variation in performance of neona-tal intensive care units in the United States. JAMA Pediatr. 2017;171(3):e164396.
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Yee WH, Soraisham AS, Shah VS, Aziz K, Yoon W, Lee SK (February 2012). "Incidence and timing of presentation of necrotizing enterocolitis in preterm infants".
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About 7% of those who are born prematurely develop NEC; however the odds of an infant developing this illness is directly related to the
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Monitoring is clinical, although serial supine and left lateral decubitus abdominal X-rays should be performed every six hours.
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output to the distal bowel. This refeeding process is believed to improve bowel adaptation and aid in advancement of feeds.
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The exact cause is unclear. However, several risk factors have been identified. Consistently described risk factors include
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compared with those fed human milk supplemented with cow's milk-based infant formula products noted a 77% reduction in NEC.
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Alimentary tract of infant showing intestinal necrosis, pneumatosis intestinalis, and perforation site (arrow) (autopsy)
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have not been consistently implicated with the development of NEC. Other risk factors potentially implicated include
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Diagnosis is usually suspected clinically, but often requires the aid of diagnostic imaging, most commonly
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Panigrahi P (2006). "Necrotizing enterocolitis: a practical guide to its prevention and management".
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Christian VJ, Polzin E, Welak S (August 2018). "Nutrition Management of Necrotizing Enterocolitis".
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In the case of an infant whose bowel is left in discontinuity, the surgical creation of a mucous
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Heird WC, Gomez MR (June 1994). "Total parenteral nutrition in necrotizing enterocolitis".
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Bode L, Contractor N, Barile D, Pohl N, Prudden AR, Boons GJ, et al. (October 2016).
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Ziegler EE, Carlson SJ (March 2009). "Early nutrition of very low birth weight infants".
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Mild intestinal signs (abdominal distention, increased gastric residuals, bloody stools)
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Close-up of intestine of infant showing necrosis and pneumatosis intestinalis (autopsy)
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Schanler RJ, Abrams SA, Kim MS. Management of necrotizing enterocolitis in newborns.
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involved, the need for surgical intervention, and the infant's clinical appearance.
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or connection to the distal bowel may be helpful, as this allows for refeeding of
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Prevention includes the use of breast milk and probiotics. A 2012 policy by the
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Where the disease is not halted through medical treatment alone, or when the
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Travers CP, Clark RH, Spitzer AR, Das A, Garite TJ, Carlo WA (March 2017).
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Been JV, Lievense S, Zimmermann LJ, Kramer BW, Wolfs TG (February 2013).
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Additional intestinal signs (striking abdominal distention, peritonitis)
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American Academy of Pediatrics, Section on Breastfeeding (March 2012).
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Additional intestinal signs (absent bowel sounds, abdominal tenderness)
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The exact cause is unclear. Several risk factors have been implicated:
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Sharif S, Meader N, Oddie SJ, Rojas-Reyes MX, McGuire W (July 2023).
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of the intestines. Diagnosis is based on symptoms and confirmed with
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Czyrko C, Del Pin CA, O'Neill JA, Peckham GJ, Ross AJ (April 1991).
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Additional laboratory changes (metabolic and respiratory acidosis,
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Rich BS, Dolgin SE (December 2017). "Necrotizing Enterocolitis".
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Lin PW, Stoll BJ (October 2006). "Necrotising enterocolitis".
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Xu J, Murphy SL, Kochanek KD, Bastian BA (February 2016).
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measures may also be required. Complications may include
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The Journal of Maternal-Fetal & Neonatal Medicine
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if extensive portions of the bowel must be removed.
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Unsourced material may be challenged and 3286:Esophageal intramural pseudodiverticulosis 3148: 3134: 2450: 2436: 2103: 1655: 1545: 1385: 1383: 1234:Lu Q, Cheng S, Zhou M, Yu J (April 2017). 982: 978: 976: 974: 972: 925: 2164: 2138: 2080: 2031: 1982: 1933: 1884: 1839: 1743: 1728:"Breastfeeding and the use of human milk" 1639: 1528: 1518: 1389: 1292: 1251: 1210: 1169: 1120: 1101:Seminars in Fetal & Neonatal Medicine 1094: 970: 968: 966: 964: 962: 960: 958: 956: 954: 952: 923: 921: 919: 917: 915: 913: 911: 909: 907: 905: 863:Learn how and when to remove this message 449:Intrahepatic cholestasis during pregnancy 271:intrahepatic cholestasis during pregnancy 1583: 567:Nonspecific or normal radiological signs 535:of a baby with necrotizing enterocolitis 527: 344:. Surgery is required in those who have 1627:Schanler RJ, Abrams SA, Kim MS (2016). 1380: 1026:Crocetti M, Barone MA, Oski FA (2004). 804: 14: 4428: 1656:Marino BS, Fine KS (1 December 2008). 949: 902: 633:disseminated intravascular coagulation 4270: 3514:Small intestinal bacterial overgrowth 3129: 2431: 2097: 1662:. Lippincott Williams & Wilkins. 1558: 519:for patent ductus arteriosus closure 491: 375: 2722:Infant respiratory distress syndrome 1813: 1481:The Lecturio Medical Concept Library 1051: 1049: 841:adding citations to reliable sources 808: 732:losses, support for blood pressure, 686:recommended feeding preterm infants 470: 27:Intestinal disease affecting infants 2145:The New England Journal of Medicine 1095:Rose AT, Patel RM (December 2018). 423: 24: 2727:Transient tachypnea of the newborn 935:Merck Manuals Professional Edition 548:Bell's stage 1 (suspected disease) 25: 4452: 4399:Spontaneous bacterial peritonitis 4246:Exocrine pancreatic insufficiency 2505:Twin-to-twin transfusion syndrome 2283: 2243:National Vital Statistics Reports 2139:Neu J, Walker WA (January 2011). 1046: 736:, and prompt antibiotic therapy. 609:Bell's stage 3 (advanced disease) 573:Bell's stage 2 (definite disease) 4441:Gastrointestinal tract disorders 4144:Secondary sclerosing cholangitis 3023:Vertically transmitted infection 1404:10.2165/00148581-200608030-00002 883: 813: 662: 650: 3385:Gastric antral vascular ectasia 3380:Portal hypertensive gastropathy 3257:Gastroesophageal reflux disease 3115:Fetal Alcohol Spectrum Disorder 3065:Group B streptococcal infection 2633:Intrauterine growth restriction 2227: 2132: 2048: 1999: 1950: 1901: 1856: 1807: 1764: 1719: 1676: 1649: 1620: 1494: 1469: 1426: 1370: 1361: 1352: 1309: 1287:(4): 414–8, discussion 419–21. 578:Mild to moderate systemic signs 388:, increased gastric residuals, 320:Prevention includes the use of 267:intrauterine growth restriction 4139:Primary sclerosing cholangitis 3989:Hepatic veno-occlusive disease 3811:Solitary rectal ulcer syndrome 2458:Conditions originating in the 2193:Nutrition in Clinical Practice 2073:10.1002/14651858.CD001970.pub6 2024:10.1002/14651858.CD001241.pub8 1975:10.1002/14651858.CD005496.pub6 1697:10.1016/j.jpedsurg.2017.09.018 1520:10.12688/f1000research.17228.1 1268: 1227: 1186: 1137: 1088: 1019: 684:American Academy of Pediatrics 482:Formula feeding (bovine based) 128:prolonged rupture of membranes 13: 1: 4196:Sphincter of Oddi dysfunction 2807:Vitamin K deficiency bleeding 2236:"Deaths: Final Data for 2013" 2118:10.1016/s0095-5108(18)30352-x 1598:10.1016/S0140-6736(06)69525-1 895: 799:neurodevelopmental disability 677: 303:prelabor rupture of membranes 4105:Postcholecystectomy syndrome 3624:Intestinal pseudoobstruction 3232:Esophageal motility disorder 2966:Periventricular leukomalacia 2784:Persistent fetal circulation 2732:Meconium aspiration syndrome 1685:Journal of Pediatric Surgery 1294:10.1016/0022-3468(91)90988-6 1281:Journal of Pediatric Surgery 1253:10.1016/j.pedneo.2016.04.002 1074:10.1097/ANC.0000000000000940 775: 722: 523: 429:Acid-suppressing medications 7: 2875:Intraventricular hemorrhage 2141:"Necrotizing enterocolitis" 1477:"Necrotizing Enterocolitis" 1212:10.1016/j.jpeds.2012.07.012 1029:Oski's Essential Pediatrics 584:Specific radiologic signs ( 257:. Maternal factors such as 10: 4457: 4090:Gallstone / Cholelithiasis 3614:Functional colonic disease 3410:Zollinger–Ellison syndrome 2880:Germinal matrix hemorrhage 2870:Velamentous cord insertion 2761:Bronchopulmonary dysplasia 1240:Pediatrics and Neonatology 1113:10.1016/j.siny.2018.07.005 561:, temperature instability) 4384: 4263: 4204: 4118: 4075: 3921: 3912: 3865: 3819: 3774: 3660: 3547: 3437: 3424: 3299: 3291:Acute esophageal necrosis 3173: 3164: 3080: 3015: 2974: 2951: 2923: 2910:Necrotizing enterocolitis 2895: 2792: 2769: 2707: 2700: 2641: 2619:Large for gestational age 2615:Small for gestational age 2607: 2571: 2539: 2513: 2481: 2470: 2376: 2291: 1814:Bode L (September 2012). 1785:10.1080/14767050802630169 1199:The Journal of Pediatrics 1062:Advances in Neonatal Care 624:Severe radiologic signs ( 614:Severe systemic illness ( 512:Poor intestinal perfusion 452:Lack of prenatal steroids 446:Increased body mass index 410:intensive medical support 204:Necrotizing enterocolitis 191: 172: 157: 133: 105: 97: 77: 60: 40: 36:Necrotizing enterocolitis 35: 18:Necrotising enterocolitis 3390:Gastric dumping syndrome 3265:Laryngopharyngeal reflux 3252:Diffuse esophageal spasm 586:pneumatosis intestinalis 415: 291:congenital heart disease 148:infectious enterocolitis 116:congenital heart disease 4006:Alcoholic liver disease 3539:Bile acid malabsorption 3483:Peptic (duodenal) ulcer 3072:Neonatal conjunctivitis 2563:Single umbilical artery 2553:Umbilical cord prolapse 2500:Placental insufficiency 2473:complicating pregnancy, 2106:Clinics in Perinatology 553:Mild systemic disease ( 346:free air in the abdomen 4016:Hepatic encephalopathy 3400:Buried bumper syndrome 3331:Peptic (gastric) ulcer 3215:Mallory–Weiss syndrome 3158:human digestive system 3048:ureaplasma urealyticum 2756:Wilson–Mikity syndrome 2680:Brachial plexus injury 1745:10.1542/peds.2011-3552 1559:Cline M (2021-07-14). 1447:10.1542/peds.2011-2022 1330:10.1542/peds.2011-3808 536: 398:intestinal perforation 218:, decreased activity, 135:Differential diagnosis 4241:Pancreatic pseudocyst 4110:Porcelain gallbladder 3222:Zenker's diverticulum 2996:Congenital hypertonia 2887:Anemia of prematurity 2595:Shoulder presentation 2157:10.1056/NEJMra1005408 1926:10.1093/nutrit/nuw025 1877:10.1093/nutrit/nuz019 1832:10.1093/glycob/cws074 1659:Blueprints Pediatrics 997:10.1542/pir.2017-0002 531: 358:intestinal strictures 328:. Treatment includes 88:intestinal strictures 4045:Hepatorenal syndrome 3984:Budd–Chiari syndrome 3941:Autoimmune hepatitis 3766:Intestinal adhesions 3524:Short bowel syndrome 3353:Functional dyspepsia 3271:Esophageal stricture 3237:Nutcracker esophagus 3001:Congenital hypotonia 2915:Meconium peritonitis 2717:Intrauterine hypoxia 2673:Subgaleal hemorrhage 1377:1991;119(4):630-638. 985:Pediatrics in Review 837:improve this section 805:Society and advocacy 795:Short bowel syndrome 759:short bowel syndrome 734:parenteral nutrition 699:the gut are needed. 595:Laboratory changes ( 486:Intestinal dysbiosis 390:abdominal distension 348:. A number of other 299:exchange transfusion 152:Hirschsprung disease 124:exchange transfusion 4184:Choledocholithiasis 4055:Metabolic disorders 4021:Acute liver failure 3994:Portal hypertension 3946:Alcoholic hepatitis 3789:Radiation proctitis 3708:Mesenteric ischemia 3680:Gastroenterocolitis 3509:Blind loop syndrome 3319:MĂ©nĂ©trier's disease 3227:Barrett's esophagus 3110:Neonatal withdrawal 3093:Perinatal mortality 2943:Sclerema neonatorum 2799:hematologic disease 711:trials are needed. 603:in the bloodstream) 500:Antibiotic exposure 459:Placental abruption 369:intensive care unit 362:developmental delay 279:placental abruption 232:multi-organ failure 92:developmental delay 4359:Undefined location 4350:Grynfeltt–Lesshaft 4251:Pancreatic fistula 4234:Pancreatic abscess 4189:Biliary dyskinesia 4160:Mirizzi's syndrome 3661:Large and/or small 3341:Dieulafoy's lesion 3210:Boerhaave syndrome 3043:mycoplasma hominis 3028:Neonatal infection 2984:Gray baby syndrome 2961:Perinatal asphyxia 2851:Hyperbilirubinemia 2628:Postterm pregnancy 2475:labour or delivery 2377:External resources 1565:Birth Injury Guide 616:low blood pressure 597:metabolic acidosis 537: 503:Blood transfusions 492:Other risk factors 443:growth restriction 376:Signs and symptoms 354:short-gut syndrome 340:, and intravenous 338:intravenous fluids 234:, and potentially 220:blood in the stool 84:Short-gut syndrome 4423: 4422: 4419: 4418: 4259: 4258: 3861: 3860: 3718:Bowel obstruction 3420: 3419: 3123: 3122: 3011: 3010: 2861:Neonatal jaundice 2779:Pneumopericardium 2749:Pneumomediastinum 2690:Klumpke paralysis 2668:Caput succedaneum 2603: 2602: 2471:Maternal factors 2425: 2424: 2205:10.1002/ncp.10115 1914:Nutrition Reviews 1865:Nutrition Reviews 1669:978-0-7817-8251-7 1592:(9543): 1271–83. 1162:10.1136/bmj.j1039 873: 872: 865: 601:too few platelets 590:portal venous gas 559:slowed heart rate 515:Prolonged use of 506:Cardiac anomalies 471:Main risk factors 386:failure to thrive 201: 200: 197:Risk of death 25% 30:Medical condition 16:(Redirected from 4448: 4411:Pneumoperitoneum 4268: 4267: 4178:Common bile duct 4060:Wilson's disease 4050:Peliosis hepatis 3919: 3918: 3796:Proctalgia fugax 3703:Abdominal angina 3628:Ogilvie syndrome 3577:Pseudomembranous 3435: 3434: 3395:Gastric volvulus 3360:Pyloric stenosis 3171: 3170: 3156:Diseases of the 3150: 3143: 3136: 3127: 3126: 3103:Infant mortality 2938:Erythema toxicum 2930:thermoregulation 2897:Gastrointestinal 2705: 2704: 2701:Affected systems 2578: 2546: 2531:Chorioamnionitis 2524: 2495:Placenta praevia 2488: 2479: 2478: 2452: 2445: 2438: 2429: 2428: 2289: 2288: 2277: 2276: 2268: 2259: 2258: 2240: 2231: 2225: 2224: 2188: 2179: 2178: 2168: 2136: 2130: 2129: 2101: 2095: 2094: 2084: 2052: 2046: 2045: 2035: 2003: 1997: 1996: 1986: 1954: 1948: 1947: 1937: 1905: 1899: 1898: 1888: 1860: 1854: 1853: 1843: 1826:(9): 1147–1162. 1811: 1805: 1804: 1768: 1762: 1761: 1747: 1738:(3): e827–e841. 1723: 1717: 1716: 1691:(9): 1660–1664. 1680: 1674: 1673: 1653: 1647: 1643: 1637: 1636: 1624: 1618: 1617: 1581: 1575: 1574: 1572: 1571: 1556: 1543: 1542: 1532: 1522: 1498: 1492: 1491: 1489: 1487: 1473: 1467: 1466: 1441:(2): e298–e304. 1430: 1424: 1423: 1392:Paediatric Drugs 1387: 1378: 1374: 1368: 1365: 1359: 1356: 1350: 1349: 1313: 1307: 1306: 1296: 1272: 1266: 1265: 1255: 1231: 1225: 1224: 1214: 1205:(2): 236–42.e2. 1190: 1184: 1183: 1173: 1141: 1135: 1134: 1124: 1092: 1086: 1085: 1053: 1044: 1043: 1023: 1017: 1016: 980: 947: 946: 944: 942: 927: 868: 861: 857: 854: 848: 817: 809: 751:bowel perforates 666: 654: 626:pneumoperitoneum 476:Low birth weight 455:Mode of delivery 433:Chorioamnionitis 424:Maternal factors 259:chorioamnionitis 251:low birth weight 181:nasogastric tube 51:gastroenterology 33: 32: 21: 4456: 4455: 4451: 4450: 4449: 4447: 4446: 4445: 4426: 4425: 4424: 4415: 4380: 4369:Internal hernia 4255: 4200: 4165:Biliary fistula 4123: 4114: 4100:Adenomyomatosis 4095:Cholesterolosis 4071: 4065:Hemochromatosis 3936:Viral hepatitis 3908: 3857: 3815: 3801:Rectal prolapse 3770: 3737:Fecal impaction 3727:Intussusception 3690:Crohn's disease 3656: 3639:Toxic megacolon 3551: 3549:Large intestine 3543: 3488:Curling's ulcer 3441: 3439:Small intestine 3428: 3416: 3324:Gastroenteritis 3295: 3160: 3154: 3124: 3119: 3076: 3060:Neonatal sepsis 3007: 2976:Musculoskeletal 2970: 2947: 2928: 2919: 2891: 2846:Hydrops fetalis 2797: 2788: 2765: 2738:Pleural disease 2696: 2658:Cephalohematoma 2637: 2599: 2572: 2567: 2540: 2535: 2514: 2509: 2482: 2474: 2472: 2466: 2456: 2426: 2421: 2420: 2372: 2371: 2300: 2286: 2281: 2280: 2269: 2262: 2238: 2232: 2228: 2189: 2182: 2137: 2133: 2102: 2098: 2067:(1): CD001970. 2053: 2049: 2018:(8): CD001241. 2004: 2000: 1969:(7): CD005496. 1955: 1951: 1920:(10): 635–644. 1906: 1902: 1861: 1857: 1812: 1808: 1769: 1765: 1724: 1720: 1681: 1677: 1670: 1654: 1650: 1644: 1640: 1625: 1621: 1582: 1578: 1569: 1567: 1557: 1546: 1499: 1495: 1485: 1483: 1475: 1474: 1470: 1431: 1427: 1388: 1381: 1375: 1371: 1366: 1362: 1357: 1353: 1314: 1310: 1273: 1269: 1232: 1228: 1191: 1187: 1142: 1138: 1093: 1089: 1054: 1047: 1040: 1024: 1020: 991:(12): 552–559. 981: 950: 940: 938: 937:. February 2017 929: 928: 903: 898: 886: 869: 858: 852: 849: 834: 818: 807: 778: 725: 680: 670: 667: 658: 655: 642:Ultrasonography 526: 509:Neonatal anemia 494: 473: 426: 418: 378: 334:orogastric tube 315:medical imaging 307:poor blood flow 275:body mass index 243:formula feeding 31: 28: 23: 22: 15: 12: 11: 5: 4454: 4444: 4443: 4438: 4421: 4420: 4417: 4416: 4414: 4413: 4408: 4406:Hemoperitoneum 4403: 4402: 4401: 4390: 4388: 4382: 4381: 4379: 4378: 4377: 4376: 4371: 4366: 4355: 4354: 4353: 4352: 4347: 4334: 4333: 4328: 4323: 4318: 4313: 4312: 4311: 4306: 4295: 4294: 4289: 4288: 4287: 4276: 4274: 4265: 4261: 4260: 4257: 4256: 4254: 4253: 4248: 4243: 4238: 4237: 4236: 4231: 4226: 4221: 4210: 4208: 4202: 4201: 4199: 4198: 4193: 4192: 4191: 4186: 4173: 4172: 4167: 4162: 4153: 4152: 4151: 4146: 4141: 4130: 4128: 4116: 4115: 4113: 4112: 4107: 4102: 4097: 4092: 4087: 4081: 4079: 4073: 4072: 4070: 4069: 4068: 4067: 4062: 4052: 4047: 4042: 4041: 4040: 4035: 4025: 4024: 4023: 4018: 4008: 4003: 4002: 4001: 3996: 3991: 3986: 3974: 3973: 3972: 3962: 3961: 3960: 3950: 3949: 3948: 3943: 3938: 3927: 3925: 3916: 3910: 3909: 3907: 3906: 3905: 3904: 3894: 3893: 3892: 3887: 3877: 3875:Blood in stool 3871: 3869: 3863: 3862: 3859: 3858: 3856: 3855: 3850: 3848:Anal dysplasia 3845: 3840: 3835: 3825: 3823: 3817: 3816: 3814: 3813: 3808: 3803: 3798: 3793: 3792: 3791: 3780: 3778: 3772: 3771: 3769: 3768: 3763: 3762: 3761: 3751: 3750: 3749: 3739: 3734: 3729: 3724: 3715: 3713:Angiodysplasia 3710: 3705: 3694: 3693: 3692: 3682: 3677: 3676: 3675: 3664: 3662: 3658: 3657: 3655: 3654: 3648:Diverticulosis 3644:Diverticulitis 3641: 3632: 3631: 3630: 3621: 3611: 3606: 3605: 3604: 3599: 3594: 3589: 3584: 3579: 3569: 3563: 3561: 3545: 3544: 3542: 3541: 3536: 3534:Milroy disease 3531: 3526: 3521: 3516: 3511: 3506: 3504:Tropical sprue 3501: 3492: 3491: 3490: 3480: 3479: 3478: 3473: 3468: 3457: 3455: 3432: 3426:Lower GI tract 3422: 3421: 3418: 3417: 3415: 3414: 3413: 3412: 3402: 3397: 3392: 3387: 3382: 3377: 3372: 3367: 3362: 3357: 3356: 3355: 3345: 3344: 3343: 3338: 3328: 3327: 3326: 3321: 3316: 3305: 3303: 3297: 3296: 3294: 3293: 3288: 3283: 3278: 3273: 3268: 3262: 3261: 3260: 3254: 3249: 3244: 3239: 3229: 3224: 3219: 3218: 3217: 3212: 3202: 3201: 3200: 3195: 3190: 3179: 3177: 3168: 3166:Upper GI tract 3162: 3161: 3153: 3152: 3145: 3138: 3130: 3121: 3120: 3118: 3117: 3112: 3107: 3106: 3105: 3100: 3090: 3084: 3082: 3078: 3077: 3075: 3074: 3069: 3068: 3067: 3057: 3052: 3051: 3050: 3045: 3040: 3038:herpes simplex 3035: 3025: 3019: 3017: 3013: 3012: 3009: 3008: 3006: 3005: 3004: 3003: 2998: 2986: 2980: 2978: 2972: 2971: 2969: 2968: 2963: 2957: 2955: 2953:Nervous system 2949: 2948: 2946: 2945: 2940: 2934: 2932: 2921: 2920: 2918: 2917: 2912: 2907: 2901: 2899: 2893: 2892: 2890: 2889: 2884: 2883: 2882: 2872: 2866: 2865: 2864: 2863: 2858: 2848: 2843: 2842: 2841: 2836: 2831: 2826: 2821: 2810: 2809: 2803: 2801: 2790: 2789: 2787: 2786: 2781: 2775: 2773: 2771:Cardiovascular 2767: 2766: 2764: 2763: 2758: 2753: 2752: 2751: 2746: 2734: 2729: 2724: 2719: 2713: 2711: 2702: 2698: 2697: 2695: 2694: 2693: 2692: 2687: 2677: 2676: 2675: 2670: 2665: 2660: 2647: 2645: 2639: 2638: 2636: 2635: 2630: 2621: 2611: 2609: 2605: 2604: 2601: 2600: 2598: 2597: 2592: 2587: 2581: 2579: 2569: 2568: 2566: 2565: 2560: 2555: 2549: 2547: 2543:umbilical cord 2537: 2536: 2534: 2533: 2527: 2525: 2511: 2510: 2508: 2507: 2502: 2497: 2491: 2489: 2476: 2468: 2467: 2455: 2454: 2447: 2440: 2432: 2423: 2422: 2419: 2418: 2407: 2393: 2381: 2380: 2378: 2374: 2373: 2370: 2369: 2358: 2347: 2332: 2317: 2301: 2296: 2295: 2293: 2292:Classification 2285: 2284:External links 2282: 2279: 2278: 2260: 2226: 2199:(4): 476–482. 2180: 2151:(3): 255–264. 2131: 2112:(2): 389–409. 2096: 2047: 1998: 1949: 1900: 1871:(8): 541–556. 1855: 1806: 1779:(3): 191–197. 1763: 1718: 1675: 1668: 1648: 1638: 1619: 1576: 1544: 1493: 1468: 1425: 1398:(3): 151–165. 1379: 1369: 1360: 1351: 1308: 1267: 1246:(2): 165–170. 1226: 1185: 1136: 1107:(6): 374–379. 1087: 1068:(5): 333–335. 1045: 1038: 1018: 948: 900: 899: 897: 894: 890:All-In Meeting 885: 882: 871: 870: 853:September 2024 821: 819: 812: 806: 803: 777: 774: 724: 721: 679: 676: 672: 671: 668: 661: 659: 656: 649: 639: 638: 637: 636: 629: 622: 619: 606: 605: 604: 593: 582: 579: 570: 569: 568: 565: 562: 525: 522: 521: 520: 513: 510: 507: 504: 501: 498: 493: 490: 489: 488: 483: 480: 477: 472: 469: 468: 467: 464: 461: 456: 453: 450: 447: 444: 438: 435: 430: 425: 422: 417: 414: 377: 374: 295:birth asphyxia 199: 198: 195: 189: 188: 174: 170: 169: 159: 155: 154: 137: 131: 130: 120:birth asphyxia 109: 103: 102: 99: 95: 94: 81: 75: 74: 64: 58: 57: 44: 38: 37: 29: 26: 9: 6: 4: 3: 2: 4453: 4442: 4439: 4437: 4434: 4433: 4431: 4412: 4409: 4407: 4404: 4400: 4397: 4396: 4395: 4392: 4391: 4389: 4387: 4383: 4375: 4372: 4370: 4367: 4365: 4362: 4361: 4360: 4357: 4356: 4351: 4348: 4346: 4343: 4342: 4341: 4340: 4336: 4335: 4332: 4329: 4327: 4324: 4322: 4319: 4317: 4314: 4310: 4307: 4305: 4302: 4301: 4300: 4297: 4296: 4293: 4290: 4286: 4283: 4282: 4281: 4280:Diaphragmatic 4278: 4277: 4275: 4273: 4269: 4266: 4262: 4252: 4249: 4247: 4244: 4242: 4239: 4235: 4232: 4230: 4227: 4225: 4222: 4220: 4217: 4216: 4215: 4212: 4211: 4209: 4207: 4203: 4197: 4194: 4190: 4187: 4185: 4182: 4181: 4180: 4179: 4175: 4174: 4171: 4168: 4166: 4163: 4161: 4157: 4154: 4150: 4147: 4145: 4142: 4140: 4137: 4136: 4135: 4132: 4131: 4129: 4127: 4121: 4117: 4111: 4108: 4106: 4103: 4101: 4098: 4096: 4093: 4091: 4088: 4086: 4085:Cholecystitis 4083: 4082: 4080: 4078: 4074: 4066: 4063: 4061: 4058: 4057: 4056: 4053: 4051: 4048: 4046: 4043: 4039: 4036: 4034: 4031: 4030: 4029: 4028:Liver abscess 4026: 4022: 4019: 4017: 4014: 4013: 4012: 4011:Liver failure 4009: 4007: 4004: 4000: 3997: 3995: 3992: 3990: 3987: 3985: 3982: 3981: 3980: 3979: 3975: 3971: 3968: 3967: 3966: 3963: 3959: 3956: 3955: 3954: 3951: 3947: 3944: 3942: 3939: 3937: 3934: 3933: 3932: 3929: 3928: 3926: 3924: 3920: 3917: 3915: 3911: 3903: 3900: 3899: 3898: 3895: 3891: 3888: 3886: 3883: 3882: 3881: 3878: 3876: 3873: 3872: 3870: 3868: 3864: 3854: 3851: 3849: 3846: 3844: 3841: 3839: 3836: 3834: 3830: 3827: 3826: 3824: 3822: 3818: 3812: 3809: 3807: 3804: 3802: 3799: 3797: 3794: 3790: 3787: 3786: 3785: 3782: 3781: 3779: 3777: 3773: 3767: 3764: 3760: 3757: 3756: 3755: 3752: 3748: 3745: 3744: 3743: 3740: 3738: 3735: 3733: 3730: 3728: 3725: 3723: 3719: 3716: 3714: 3711: 3709: 3706: 3704: 3700: 3699: 3695: 3691: 3688: 3687: 3686: 3683: 3681: 3678: 3674: 3671: 3670: 3669: 3668:Enterocolitis 3666: 3665: 3663: 3659: 3653: 3649: 3645: 3642: 3640: 3636: 3633: 3629: 3625: 3622: 3620: 3617: 3616: 3615: 3612: 3610: 3607: 3603: 3600: 3598: 3595: 3593: 3590: 3588: 3585: 3583: 3580: 3578: 3575: 3574: 3573: 3570: 3568: 3565: 3564: 3562: 3559: 3555: 3550: 3546: 3540: 3537: 3535: 3532: 3530: 3527: 3525: 3522: 3520: 3517: 3515: 3512: 3510: 3507: 3505: 3502: 3500: 3496: 3495:Malabsorption 3493: 3489: 3486: 3485: 3484: 3481: 3477: 3474: 3472: 3469: 3467: 3464: 3463: 3462: 3459: 3458: 3456: 3453: 3449: 3445: 3440: 3436: 3433: 3431: 3427: 3423: 3411: 3408: 3407: 3406: 3403: 3401: 3398: 3396: 3393: 3391: 3388: 3386: 3383: 3381: 3378: 3376: 3373: 3371: 3370:Gastroparesis 3368: 3366: 3363: 3361: 3358: 3354: 3351: 3350: 3349: 3346: 3342: 3339: 3337: 3336:Cushing ulcer 3334: 3333: 3332: 3329: 3325: 3322: 3320: 3317: 3315: 3312: 3311: 3310: 3307: 3306: 3304: 3302: 3298: 3292: 3289: 3287: 3284: 3282: 3281:Megaesophagus 3279: 3277: 3274: 3272: 3269: 3266: 3263: 3258: 3255: 3253: 3250: 3248: 3245: 3243: 3240: 3238: 3235: 3234: 3233: 3230: 3228: 3225: 3223: 3220: 3216: 3213: 3211: 3208: 3207: 3206: 3203: 3199: 3196: 3194: 3191: 3189: 3186: 3185: 3184: 3181: 3180: 3178: 3176: 3172: 3169: 3167: 3163: 3159: 3151: 3146: 3144: 3139: 3137: 3132: 3131: 3128: 3116: 3113: 3111: 3108: 3104: 3101: 3099: 3096: 3095: 3094: 3091: 3089: 3086: 3085: 3083: 3079: 3073: 3070: 3066: 3063: 3062: 3061: 3058: 3056: 3053: 3049: 3046: 3044: 3041: 3039: 3036: 3034: 3031: 3030: 3029: 3026: 3024: 3021: 3020: 3018: 3014: 3002: 2999: 2997: 2994: 2993: 2992: 2991: 2987: 2985: 2982: 2981: 2979: 2977: 2973: 2967: 2964: 2962: 2959: 2958: 2956: 2954: 2950: 2944: 2941: 2939: 2936: 2935: 2933: 2931: 2926: 2922: 2916: 2913: 2911: 2908: 2906: 2903: 2902: 2900: 2898: 2894: 2888: 2885: 2881: 2878: 2877: 2876: 2873: 2871: 2868: 2867: 2862: 2859: 2857: 2854: 2853: 2852: 2849: 2847: 2844: 2840: 2837: 2835: 2832: 2830: 2827: 2825: 2822: 2820: 2817: 2816: 2815: 2812: 2811: 2808: 2805: 2804: 2802: 2800: 2795: 2791: 2785: 2782: 2780: 2777: 2776: 2774: 2772: 2768: 2762: 2759: 2757: 2754: 2750: 2747: 2745: 2742: 2741: 2740: 2739: 2735: 2733: 2730: 2728: 2725: 2723: 2720: 2718: 2715: 2714: 2712: 2710: 2706: 2703: 2699: 2691: 2688: 2686: 2683: 2682: 2681: 2678: 2674: 2671: 2669: 2666: 2664: 2661: 2659: 2656: 2655: 2654: 2653: 2649: 2648: 2646: 2644: 2640: 2634: 2631: 2629: 2625: 2624:Preterm birth 2622: 2620: 2616: 2613: 2612: 2610: 2606: 2596: 2593: 2591: 2588: 2586: 2583: 2582: 2580: 2577: 2576: 2570: 2564: 2561: 2559: 2556: 2554: 2551: 2550: 2548: 2545: 2544: 2538: 2532: 2529: 2528: 2526: 2523: 2522: 2518: 2512: 2506: 2503: 2501: 2498: 2496: 2493: 2492: 2490: 2487: 2486: 2480: 2477: 2469: 2465: 2464:fetal disease 2461: 2453: 2448: 2446: 2441: 2439: 2434: 2433: 2430: 2417: 2413: 2412: 2408: 2406: 2403: 2399: 2398: 2394: 2392: 2388: 2387: 2383: 2382: 2379: 2375: 2368: 2364: 2363: 2359: 2357: 2353: 2352: 2348: 2346: 2342: 2341: 2337: 2333: 2331: 2327: 2326: 2322: 2318: 2316: 2312: 2311: 2307: 2303: 2302: 2299: 2294: 2290: 2274: 2267: 2265: 2256: 2252: 2248: 2244: 2237: 2230: 2222: 2218: 2214: 2210: 2206: 2202: 2198: 2194: 2187: 2185: 2176: 2172: 2167: 2162: 2158: 2154: 2150: 2146: 2142: 2135: 2127: 2123: 2119: 2115: 2111: 2107: 2100: 2092: 2088: 2083: 2078: 2074: 2070: 2066: 2062: 2058: 2051: 2043: 2039: 2034: 2029: 2025: 2021: 2017: 2013: 2009: 2002: 1994: 1990: 1985: 1980: 1976: 1972: 1968: 1964: 1960: 1953: 1945: 1941: 1936: 1931: 1927: 1923: 1919: 1915: 1911: 1904: 1896: 1892: 1887: 1882: 1878: 1874: 1870: 1866: 1859: 1851: 1847: 1842: 1837: 1833: 1829: 1825: 1821: 1817: 1810: 1802: 1798: 1794: 1790: 1786: 1782: 1778: 1774: 1767: 1760: 1755: 1751: 1746: 1741: 1737: 1733: 1729: 1722: 1714: 1710: 1706: 1702: 1698: 1694: 1690: 1686: 1679: 1671: 1665: 1661: 1660: 1652: 1642: 1634: 1630: 1623: 1615: 1611: 1607: 1603: 1599: 1595: 1591: 1587: 1580: 1566: 1562: 1555: 1553: 1551: 1549: 1540: 1536: 1531: 1526: 1521: 1516: 1512: 1508: 1507:F1000Research 1504: 1497: 1482: 1478: 1472: 1464: 1460: 1456: 1452: 1448: 1444: 1440: 1436: 1429: 1421: 1417: 1413: 1409: 1405: 1401: 1397: 1393: 1386: 1384: 1373: 1364: 1355: 1347: 1343: 1339: 1335: 1331: 1327: 1323: 1319: 1312: 1304: 1300: 1295: 1290: 1286: 1282: 1278: 1271: 1263: 1259: 1254: 1249: 1245: 1241: 1237: 1230: 1222: 1218: 1213: 1208: 1204: 1200: 1196: 1189: 1181: 1177: 1172: 1167: 1163: 1159: 1155: 1151: 1147: 1140: 1132: 1128: 1123: 1118: 1114: 1110: 1106: 1102: 1098: 1091: 1083: 1079: 1075: 1071: 1067: 1063: 1059: 1052: 1050: 1041: 1039:9780781737708 1035: 1031: 1030: 1022: 1014: 1010: 1006: 1002: 998: 994: 990: 986: 979: 977: 975: 973: 971: 969: 967: 965: 963: 961: 959: 957: 955: 953: 936: 932: 926: 924: 922: 920: 918: 916: 914: 912: 910: 908: 906: 901: 893: 891: 884:NEC Symposium 881: 878: 867: 864: 856: 846: 842: 838: 832: 831: 827: 822:This section 820: 816: 811: 810: 802: 800: 796: 790: 786: 784: 773: 771: 767: 762: 760: 756: 752: 747: 745: 740: 737: 735: 731: 720: 717: 712: 709: 704: 700: 697: 691: 689: 685: 675: 665: 660: 653: 648: 647: 646: 643: 634: 630: 627: 623: 620: 617: 613: 612: 610: 607: 602: 598: 594: 591: 587: 583: 580: 577: 576: 574: 571: 566: 563: 560: 556: 552: 551: 549: 546: 545: 544: 542: 534: 530: 518: 514: 511: 508: 505: 502: 499: 497:Acute hypoxia 496: 495: 487: 484: 481: 478: 475: 474: 465: 463:Pre-eclampsia 462: 460: 457: 454: 451: 448: 445: 442: 439: 437:Cocaine abuse 436: 434: 431: 428: 427: 421: 413: 411: 407: 404:and systemic 403: 399: 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Index

Necrotising enterocolitis
Specialty
Pediatrics
gastroenterology
neonatology
Symptoms
vomiting
bile
Complications
Short-gut syndrome
intestinal strictures
developmental delay
Risk factors
Preterm birth
congenital heart disease
birth asphyxia
exchange transfusion
prolonged rupture of membranes
Differential diagnosis
Sepsis
anal fissure
infectious enterocolitis
Hirschsprung disease
Breast milk
probiotics
Bowel rest
nasogastric tube
antibiotics
Prognosis
poor feeding

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