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Necrotising enterocolitis (NEC) is a severe gastrointestinal disease primarily affecting premature and low-birth-weight infants. It involves inflammation and bacterial invasion of the intestinal wall, which can lead to tissue death, perforation, and systemic infection. NEC is considered a medical emergency, as it can progress rapidly and result in life-threatening complications if not treated promptly.

The exact cause of NEC is multifactorial. Prematurity plays a significant role because the immature gut has underdeveloped immune defenses and impaired intestinal motility. Other contributing factors include intestinal ischemia, formula feeding (rather than breast milk), bacterial colonization, and an exaggerated inflammatory response.

Symptoms of NEC often appear in the first few weeks of life and can include feeding intolerance, abdominal distension, vomiting (sometimes bilious), bloody stools, lethargy, and temperature instability. Laboratory findings may show metabolic acidosis, thrombocytopenia, and elevated inflammatory markers. Radiographic imaging, such as abdominal X-rays, can reveal pneumatosis intestinalis (air within the intestinal wall), portal venous gas, or free air if perforation occurs.

Treatment depends on the severity of the condition. Initial management typically involves stopping oral feeds, providing intravenous fluids and nutrition, administering broad-spectrum antibiotics, and closely monitoring the infant. Severe cases with intestinal perforation or necrosis may require surgical intervention to remove damaged sections of the intestine. Long-term complications can include short bowel syndrome and growth delays. Early recognition and intervention significantly improve outcomes for infants with NEC.

This summary emphasizes the critical need for vigilant neonatal care, particularly for preterm infants, to prevent and manage necrotising enterocolitis effectively.