15 May 2019 Necrotising enterocolitis is a very serious disease that occurs mainly: In premature and very low birth weight infants (less than 1.5 g) In seriously ill term newborns (e.g. complex heart disease). Causes and severity of necrotising enterocolitis Necrotising enterocolitis is caused by insufficient blood circulation in the bowel. The intestinal wall is very thin and sometimes splits in one or more places. As a result, intestinal contents leak into the abdominal cavity, causing peritonitis. Bacteria pass into the bloodstream through the thin intestinal wall causing a very serious blood infection . Sometimes part of the intestine becomes necrotic and has to be removed. This disease has varying degrees of severity . The newborn may: Fall ill suddenly; Become unstable; No longer tolerate feeds; Have a very distended and painful abdomen; Have blood in the stools. When is surgery required in necrotising enterocolitis? Necrotising enterocolitis may be required when there is: Evidence of perforation of the bowel; Rapid, fast deterioration of the newborn’s clinical condition. What does the procedure consist of? The surgery consists of lavage of the abdominal cavity to remove: Leaked intestinal contents; Non-viable affected or perforated bowel. This surgery can be used: To reconstruct the bowel immediately; To build an intestinal ostomy (opening in the skin). In this case, a subsequent procedure will be needed to close the ostomy. Postoperative complications depend on the amount of bowel removed from the newborn. This conditions the treatment and prognosis. Intestinal stenosis (narrowing) is one of the complications that occur quite commonly. It affects: Intestinal transit; Food tolerance. What is the prognosis for necrotising enterocolitis? The prognosis of necrotising enterocolitis basically depends on: The amount of affected bowel removed; Birth weight; Gestational age. Short bowel syndrome develops in cases of very large bowel loss. This worsens the patient’s overall prognosis, prolongs hospitalisation and requires: Parenteral nutrition over an extended period; A slow, late introduction of enteral feeding. This article was written with the support of physicians and other clinical professionals from the Hospital da Luz network. . The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
