Necrotizing enterocolitis [Neurosurgery Wiki]

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====== Necrotizing enterocolitis ======


Necrotizing [[enterocolitis]] (NEC) is a medical condition where a portion of the bowel dies. It typically occurs in newborns that are either premature or otherwise unwell.

Symptoms may include poor feeding, bloating, decreased activity, blood in the stool, or vomiting of bile.


The exact cause is unclear.

Risk factors include congenital heart disease, birth asphyxia, exchange transfusion, and prolonged rupture of membranes.

The underlying mechanism is believed to involve a combination of poor blood flow and infection of the intestines.

Diagnosis is based on symptoms and confirmed with medical imaging.

Prevention includes the use of breast milk and probiotics.

Treatment includes bowel rest, oralgastric tube, intravenous fluids, and intravenous antibiotics.

Surgery is required in those who have free air in the abdomen.

A number of other supportive measures may also be required.

Complications may include short-gut syndrome, intestinal strictures, or developmental delay.

About 7% of those that are born premature develop necrotizing enterocolitis.

Onset is typically in the first four weeks of life.

Among those affected about 25% die.

The sexes are affected equally frequently.

The condition was first described in between 1888 and 1891.
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In-hospital mortality in [[preterm]] infants with severe [[intraventricular Hemorrhage]] decreased over the last decade, whereas major [[neonatal]] morbidities increased, particularly surgical [[necrotizing enterocolitis]] (NEC) and [[sepsis]]. 
A study suggests the importance of multidisciplinary specialized medical and surgical neonatal intensive care in preterm infants with severe [[intraventricular Hemorrhage]]
((Choi EK, Kim HJ, Je BK, Choi BM, Kim SD. Morbidity and Mortality Trends in Preterm Infants of <32 Weeks Gestational Age with Severe Intraventricular Hemorrhage : A 14-Year Single-Center Retrospective Study. J Korean Neurosurg Soc. 2023 Mar 9. doi: 10.3340/jkns.2022.0264. Epub ahead of print. PMID: 36891659.)).