Posted: June 15, 2015

Necrotizing enterocolitis (NEC) occurs in premature infants, and involves damage to the intestine. It can range from a small mucosal lesion to full thickness necrosis, or death, of a portion of the bowel.

Initial symptoms included feeding intolerance, abdominal distention, temperature instability, lethargy, vomiting, and bloody stools. If not promptly diagnosed and treated, NEC can lead to bowel perforation, peritonitis, sepsis and death.

The diagnosis of NEC is usually suspected clinically, but is confirmed with x-rays or other radiologic studies. Diagnostic studies help identify the severity or Bell’s stage of the disease.

Bell’s Stage 1 or suspected disease:

  • Mild systemic disease with apnea, bradycardia and temperature instability
  • Mild abdominal distention, feeding residuals and bloody stools
  • Normal or non-specific radiologic signs

Bell’s Stage 2 or definite disease:

  • Moderate systemic symptoms
  • Pneumatosis intestinalis or portal venous air on radiology studies
  • Blood test results showing metabolic acidosis or thrombocytopenia

Bell’s Stage 3 or advanced disease:

  • Severe systemic illness with unstable vital signs or low blood pressure
  • Severe abdominal distention or peritonitis
  • Pneumoperitoneum or air in the abdominal cavity
  • Worsening blood test results, respiratory acidosis or disseminated intravascular coagulation (DIC)

NEC can develop at any time in the absence of medical negligence, but once it is suspected, treatments must be started immediately to minimize the extent of damage to the bowel. Treatment consists of supportive care including bowel rest by stopping feedings, decompression of the intestines with intermittent suction, fluid and electrolyte replacement, blood pressure support and antibiotic therapy. If the destruction is not halted, it can lead to bowel perforation requiring immediate surgery, bowel resection, colostomy placement, or even death.

If your infant had NEC, and you believe it was not properly treated and that led to a serious permanent intestinal injury or wrongful death, you may want to contact an experienced medical malpractice attorney for additional information.