Necrotizing enterocolitis

Necrotizing enterocolitis (NEC) is a medical condition primarily seen in prematureinfants, where portions of the bowel undergo necrosis(tissue death).

Signs and symptoms

The condition is typically seen within days after birth, and initial symptoms include feeding intolerance, abdominal distension and bloody stools. Symptoms may progress rapidly to abdominal discoloration with intestinal perforation and peritonitis and systemic hypotension requiring intensive medical support.

Treatment

Treatment can be either medical or surgical. Initial medical treatment includes bowel rest and decompression with intermittent gastric suction. Immediate treatment with intravenousantibiotics, including vancomycinand gentamicinwill begin, as well as periodic (every 6-8 hours) abdominal x-rays monitoring for intestinal perforation. The deteriorating bowel can be visualized on X-rayas an area of "bubbling" within the wall of the bowel known as pneumotosis intestinalis. After several days, medical treatment will begin to show slow down and reversal of bowel deterioration in many cases. Where the disease is not halted through medical treatment alone, or when the bowel perforates, immediate emergency surgery to resect the dead bowel is required. This will require a colostomy, which may be able to be reversed at a later time. Some children may suffer later as a result of short bowel syndromeif extensive portions of the bowel had to be removed.

Cause

NEC has no definitive known cause. A contagious agent is suspected, as cluster outbreaks in neonatal intensive care units(NICUs) are seen, but it is suspected that a combination of contagion, inherent weakness in the bowel, and some timing of the initiation of oral feedings are factors. NEC is almost never seen in infants before oral feedings are initiated.

Prognosis

Typical recovery from NEC if medical, non-surgical treatment succeeds includes 10-14 days or more NPO, and then demonstrated ability to resume feedings and gain weight. Recovery from NEC alone may be compromised by other multiple conditions that frequently accompany prematurity.vi:Viêm ru?t ho?i t?

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It uses material from the http://en.wikipedia.org/wiki/Necrotizing+enterocolitis Wikipedia article Necrotizing enterocolitis.