Symptoms:

Symptoms may come on slowly or suddenly, and may include:

• Abdominal distention
• Blood in the stool
• Diarrhea
• Feeding intolerance
• Lethargy
• Temperature instability
• Vomiting

Signs and tests:

• Abdominal x-ray
• Stool for occult blood test (guaiac)
• Elevated white blood cell count in a CBC
• Thrombocytopenia (low platelet count)
• Lactic acidosis

Treatment:

In an infant suspected of having necrotizing enterocolitis, feedings are stopped and gas is relieved from the bowel by inserting a small tube into the stomach. Intravenous fluid replaces formula or breast milk. Antibiotic therapy is started. The infant's condition is monitored with abdominal x-rays, blood tests, and blood gases.

Surgery will be needed if there is a hole in the intestines or peritonitis (inflammation of the abdominal wall). The dead bowel tissue is removed and a colostomy or ileostomy is performed. The bowel is then reconnected several weeks or months later when the infection and inflammation have healed.

Expectations (prognosis):

Necrotizing enterocolitis is a serious disease with a death rate approaching 25%. Early, aggressive treatment helps improve the outcome.

Complications:

• Intestinal perforation
• Intestinal stricture
• Peritonitis
• Sepsis

Calling your health care provider:

If any symptoms of necrotizing enterocolitis develop, especially in an infant that has recently been hospitalized for illness or prematurity, go to the emergency room or call the local emergency number (such as 911).