Necrotizing Enterocolitis Questions & Answers

Updated: Dec 27, 2017
  • Author: Shelley C Springer, JD, MD, MSc, MBA, FAAP; Chief Editor: Muhammad Aslam, MD  more...
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Questions & Answers

Overview

What is necrotizing enterocolitis (NEC)?

How is the onset of necrotizing enterocolitis (NEC) characterized in infants?

What are systemic signs of necrotizing enterocolitis (NEC)?

Which physical findings are characteristic of necrotizing enterocolitis (NEC)?

What are systemic signs of necrotizing enterocolitis (NEC)?

Which studies are performed in the evaluation of necrotizing enterocolitis (NEC)?

Which lab findings suggest necrotizing enterocolitis (NEC)?

What is the role of abdominal radiography in the diagnosis of necrotizing enterocolitis (NEC)?

Which radiographic findings suggest necrotizing enterocolitis (NEC)?

What are the advantages of abdominal ultrasonography in the diagnosis of necrotizing enterocolitis (NEC)?

What is the initial treatment for necrotizing enterocolitis (NEC)?

What is the treatment for Bell stages IA and IB (suspected) necrotizing enterocolitis (NEC)?

What is the treatment for Bell stages IIA and IIB (definite) necrotizing enterocolitis (NEC)?

What is the treatment for Bell stage IIIA (advanced) necrotizing enterocolitis (NEC)?

What are the indications for surgical intervention in necrotizing enterocolitis (NEC)?

What is necrotizing enterocolitis (NEC)?

What is the prevalence of necrotizing enterocolitis (NEC)?

What parts of the bowel are commonly affected in necrotizing enterocolitis (NEC)?

What is the historical origin of necrotizing enterocolitis (NEC)?

What has led to an increase in necrotizing enterocolitis (NEC) in neonatal intensive care units (NICUs)?

When does necrotizing enterocolitis (NEC) typically occur?

What are the disease characteristics of necrotizing enterocolitis (NEC)?

What are systemic signs of necrotizing enterocolitis (NEC)?

Which nonspecific lab abnormalities suggest necrotizing enterocolitis (NEC)?

What is the pathogenesis of necrotizing enterocolitis s (NEC)?

What is the role of oligofructose in the pathogenesis of necrotizing enterocolitis (NEC)?

What is the role of infectious organisms in the etiology of necrotizing enterocolitis (NEC)?

What is the evidence in support of an infectious etiology in necrotizing enterocolitis (NEC)?

What is the role of diminished blood flow in the pathogenesis of necrotizing enterocolitis (NEC) in infants?

What is the role of intestinal ischemia in the pathogenesis of necrotizing enterocolitis (NEC)?

Why is maturation of the GI system believed to be an etiologic factor in necrotizing enterocolitis (NEC)?

Why are premature infants at highest risk for enterocolitis (NEC)?

What is the role of intestinal mucosal immaturity in the etiology of necrotizing enterocolitis (NEC)?

Why is human milk thought to be protective against necrotizing enterocolitis (NEC)?

What is the role of enteral feedings in the etiology of necrotizing enterocolitis (NEC)?

What is the role of genetics in the etiology of necrotizing enterocolitis (NEC)?

Which medications have been implicated as risk factors for the development of necrotizing enterocolitis (NEC)?

What is the racial predilections for necrotizing enterocolitis (NEC)?

What is the incidence of necrotizing enterocolitis (NEC) in the US?

What is the global incidence of necrotizing enterocolitis (NEC)?

Which infants are at highest risk for necrotizing enterocolitis (NEC)?

What is the prognosis of necrotizing enterocolitis (NEC)?

What is the incidence of intestinal stricture in necrotizing enterocolitis (NEC)?

What is the incidence of short-gut syndrome after intestinal resection to treat necrotizing enterocolitis (NEC)?

What causes cholestatic liver disease in patients with necrotizing enterocolitis (NEC)?

What is the incidence of recurrent necrotizing enterocolitis (NEC)?

What is the prevalence of neurodevelopmental disorders in patients with necrotizing enterocolitis (NEC)?

What is the prevalence of sepsis in necrotizing enterocolitis (NEC)?

Presentation

What are the signs and symptoms of necrotizing enterocolitis (NEC)?

Which clinical history is characteristic of necrotizing enterocolitis (NEC) in a term baby?

Which clinical history is characteristic of necrotizing enterocolitis (NEC) in a premature baby?

Which physical findings are characteristic of necrotizing enterocolitis (NEC)?

What are GI signs of necrotizing enterocolitis (NEC)?

What are the systemic signs of necrotizing enterocolitis (NEC)?

What is the insidious onset of necrotizing enterocolitis (NEC)?

When is surgical consultation indicated for necrotizing enterocolitis (NEC)?

DDX

What are the challenges in differentiating necrotizing enterocolitis (NEC) from other benign conditions?

Which conditions should be included in the differential diagnoses of necrotizing enterocolitis (NEC)?

What are the differential diagnoses for Necrotizing Enterocolitis?

Workup

Which studies are performed in the initial workup for necrotizing enterocolitis (NEC)?

How frequently should a complete blood count (CBC) be repeated in the workup of necrotizing enterocolitis (NEC)?

Which lab findings suggest sepsis in necrotizing enterocolitis (NEC)?

Which findings on red blood cell count are significant in the workup of necrotizing enterocolitis (NEC)?

What is the role of a platelet count in the workup of necrotizing enterocolitis (NEC)?

What is the role of a blood culture in the workup of necrotizing enterocolitis (NEC)?

What is the role of serum electrolytes in the workup of necrotizing enterocolitis (NEC)?

What is the role of serum sodium in the workup of necrotizing enterocolitis (NEC)?

What is the significance of metabolic acidosis in patients with necrotizing enterocolitis (NEC)?

What is the role biomarkers in the diagnosis of necrotizing enterocolitis (NEC)?

What is the role of imaging in the workup of necrotizing enterocolitis (NEC)?

What is the role of arterial blood gases in the workup of necrotizing enterocolitis (NEC)?

Which finding on abdominal radiography indicates necrotizing enterocolitis (NEC)?

What is the role of abdominal radiography in the workup of necrotizing enterocolitis (NEC)?

What does a finding of abdominal free air indicate in the workup of necrotizing enterocolitis (NEC)?

What is the appearance of portal gas on abdominal radiography in necrotizing enterocolitis (NEC)?

What is the significance of loop distention on abdominal radiography in the evaluation of necrotizing enterocolitis (NEC)?

What is the significance of a finding on abdominal radiography of ascites in the evaluation for necrotizing enterocolitis (NEC)?

What are the advantages and disadvantages of abdominal ultrasonography in the workup of necrotizing enterocolitis (NEC)?

What is the role of abdominal ultrasonography in the workup of necrotizing enterocolitis (NEC)?

What is the role of an upper GI series in the evaluation of necrotizing enterocolitis (NEC)?

What is the role of paracentesis in the workup of necrotizing enterocolitis (NEC)?

Which histologic findings are characteristic of necrotizing enterocolitis (NEC)?

What system is used to stage necrotizing enterocolitis (NEC)?

What are the characteristics of Bell stage I necrotizing enterocolitis (NEC)?

What are the characteristics of Bell stage IIA necrotizing enterocolitis (NEC)?

What are the characteristics of Bell stage IIB necrotizing enterocolitis (NEC)?

What are the characteristics of Bell stage III necrotizing enterocolitis (NEC)?

Treatment

What is the prevalence of enterocolitis (NEC) in premature infants?

What is the treatment for mild (Bell stage II) necrotizing enterocolitis (NEC)?

What may exacerbate early necrotizing enterocolitis (NEC)?

How can the risk and severity of necrotizing enterocolitis (NEC) be moderated?

What is the role of abdominal decompression in the treatment of necrotizing enterocolitis (NEC)?

Which specialist consultations are beneficial in the treatment of necrotizing enterocolitis (NEC)?

What is the indication for transfer of patients with necrotizing enterocolitis (NEC)?

Which treatments for necrotizing enterocolitis (NEC) are under investigation?

What are the initial treatment options for Bell stage I or II necrotizing enterocolitis (NEC)?

What is the treatment for Bell stages IA and IB necrotizing enterocolitis (NEC)?

What is included in the treatment of Bell stages IIA and IIB necrotizing enterocolitis (NEC)?

What is the treatment for Bell stage IIIA necrotizing enterocolitis (NEC)?

What is the treatment for Bell stage IIIB necrotizing enterocolitis (NEC)?

When is surgery indicated for necrotizing enterocolitis (NEC)?

What are contraindications to surgery of necrotizing enterocolitis (NEC)?

What is included in preoperative care for necrotizing enterocolitis (NEC)?

What are the intraoperative details of surgery for necrotizing enterocolitis (NEC)?

When is enterostomy closure performed in the surgery for necrotizing enterocolitis (NEC)?

What is the role of peritoneal drainage in the treatment of necrotizing enterocolitis (NEC)?

What is included in postoperative care for necrotizing enterocolitis (NEC)?

What is the role of parenteral nutrition in the treatment of necrotizing enterocolitis (NEC)?

When are enteral feedings restarted in the treatment of necrotizing enterocolitis (NEC)?

What are the feeding strategies for deterrence and prevention of necrotizing enterocolitis (NEC)?

What are pharmacologic strategies for the deterrence and prevention of necrotizing enterocolitis (NEC)?

What is included in long-term monitoring of infants with necrotizing enterocolitis (NEC)?

Medications

What is the role of pharmacologic therapy for necrotizing enterocolitis (NEC)?

Which medications in the drug class Probiotics are used in the treatment of Necrotizing Enterocolitis?

Which medications in the drug class Antifungal Agents are used in the treatment of Necrotizing Enterocolitis?

Which medications in the drug class Opioid Analgesics are used in the treatment of Necrotizing Enterocolitis?

Which medications in the drug class Glucocorticosteroids are used in the treatment of Necrotizing Enterocolitis?

Which medications in the drug class Volume Expanders are used in the treatment of Necrotizing Enterocolitis?

Which medications in the drug class Vasopressors are used in the treatment of Necrotizing Enterocolitis?

Which medications in the drug class Antibiotics are used in the treatment of Necrotizing Enterocolitis?