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Necrotizing Enterocolitis

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Abstract

Necrotizing enterocolitis (NEC) occurs in preterm, low-birth-weight infants and has an increasing incidence. Typically, it presents with lethargy, feeding intolerance, bloody stools, respiratory distress, hypoperfusion, and a tender/distended abdomen, whereas more advanced disease will demonstrate systemic symptoms. The Modified Bell’s Staging Criteria is often used to clinically and radiographically diagnose and stage NEC. Management begins with gastric decompression, stopping enteral nutrition, broad intravenous (IV) antibiotics, and correction of respiratory and metabolic derangements. If a patient meets criteria for surgical intervention and is >1500 g, then may proceed with laparotomy. If <1500 g and hemodynamically unstable, a percutaneous drain may be placed in the right lower quadrant to help stabilize the patient.

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References

  1. Castle SL, Speer AL, Grikscheit TC, Ford H. Necrotizing enterocolitis. In: Ziegler MM, Azizkhan RG, Dv A, Weber TR, editors. Operative pediatric surgery. New York: McGraw-Hill Education; 2014.

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  2. Tanner SM, Berryhill TF, Ellenburg JL, Jilling T, Cleveland DS, Lorenz RG, et al. Pathogenesis of necrotizing enterocolitis: modeling the innate immune response. Am J Pathol. 2015;185(1):4–16.

    Article  CAS  Google Scholar 

  3. Neu J. Necrotizing enterocolitis. World Rev Nutr Diet. 2014;110:253–63.

    Article  Google Scholar 

  4. Walsh MC, Kliegman RM. Necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin N Am. 1986;33(1):179–201.

    Article  CAS  Google Scholar 

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Correspondence to David A. Lanning .

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DeAntonio, J.H., Parrish, D.W., Lanning, D.A. (2019). Necrotizing Enterocolitis. In: Docimo Jr., S., Pauli, E. (eds) Clinical Algorithms in General Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-98497-1_131

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  • DOI: https://doi.org/10.1007/978-3-319-98497-1_131

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-98496-4

  • Online ISBN: 978-3-319-98497-1

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