Necrotizing enterocolitis

Necrotizing enterocolitis (NEC) is a devastating disease affecting most commonly the intestine of preterm infants. NEC is characterized by severe intestinal inflammation and intestinal necrosis and is known for its progressive nature. The onset of NEC typically occurs within the first weeks of life, and infants may initially present with subtle symptoms such as lethargy, feeding intolerance, and abdominal distension. Treatment during these early stages usually consists of nasogastric decompression, broad-spectrum antibiotics, total parenteral nutrition, and supportive care. NEC can progress into a systemic disease that can be so severe as to require ventilator support, inotropes, and surgery. Indications for surgery include pneumoperitoneum, which is indicative of intestinal perforation, and clinical deterioration over time despite maximal medical therapy. Mortality rates among neonates requiring surgery are reported to be as high as 40-50%, with no improvement of surgical outcomes over the last decades.