Necrotising Enterocolitis

Disorder affecting premature neonates, where part of the bowel becomes necrotic

Aetiology

  • Serious intestinal injury to a relatively immature gut (e.g. premature baby being fed too early) resulting in perforation

Clinical presentation

  • Intolerance to feeds
  • Vomiting, particularly with green bile
  • Generally unwell
  • Distended, tender abdomen
  • Absent bowel sounds
  • Blood in stools

Investigations

Abdominal x-ray

  • Dilated loops of bowel
  • Bowel wall oedema
  • Gas in bowel wall
  • Gas in peritoneal cavity (pneumoperitoneum) indicates perforation
notion image

Management

  • Nil by mouth, clindamycin and cefotaxime
  • Immediate referral to the neonatal surgical team