Diagnosis
The diagnosis is usually suspected clinically but often requires the aid of diagnostic imaging modalities. Radiographic signs of NEC include dilated bowel loops, paucity of gas, a "fixed loop" (unaltered gas-filled loop of bowel), pneumatosis intestinalis, portal venous gas, and pneumoperitoneum (extraluminal or "free air" outside the bowel within the abdomen). The pathognomic finding on plain films is pneumatosis intestinalis. More recently ultrasonography has proven to be useful as it may detect signs and complications of NEC before they are evident on radiographs. Diagnosis is ultimately made in 5–10% of very low-birth-weight infants (<1,500g). However, it is not known whether some underlying pathology contributes to premature birth and low birth weight.
The clinical features are divided into 3 stages:
Stage 1 — Apnea, bradycardia, lethargy, abdominal distension and vomiting.
Stage 2 — Pneumatosis intestinalis and the above features.
Stage 3 — Low blood pressure, bradycardia, acidosis, disseminated intravascular coagulation (DIC) and anuria.
Read more about this topic: Necrotizing Enterocolitis