Necrotising Enterocolitis (NEC) is a serious condition occurring mainly in premature babies where the intestine becomes swollen and inflamed may be irreversibly damaged. NEC can affect just a small part or rarely the whole intestine. It can lead to perforation in the intestine resulting in contents of the intestine leaking into the abdomen. Sometimes, the inflammation maybe fulminating and cause extensive damage to the intestines which is inoperable and lead to a baby’s demise.
Symptoms of NEC include a distended and discoloured abdomen, vomiting and blood in the stools. Babies with NEC may also show general signs of being unwell such as irregular breathing, low blood pressure and a fast heartbeat, poor feeding and lethargy.
The exact causes of NEC are still unclear, and hence prevention is often difficult. It is likely to be multifactorial (prematurity, intolerance of milk feeds, infection, poor foetal growth, rapid escalation of feeding in a baby who is unable to tolerate this). Studies have shown that babies who received only breast milk (rather than formula) are less likely to develop NEC.
NEC is diagnosed by examining the baby for signs listed above. Apart from those signs, an X-ray may show a bubbly appearance in the intestine and signs of air or gas in the liver. Air may also be found outside the intestines in the abdomen if there is a hole in the intestine. The gold standard in diagnosis rests on visualising the intestines at surgery and obtaining a pathological sample of a piece of bowel that is resected. However, not every baby with NEC undergoes surgery so diagnosis in this situation is based on history, clinical and radiological signs and working in close collaboration with a Paediatric Surgeon.
