الفهرس 
Pathogenesis of Necrotizing EnterocolitisOnly 14 pages are availabe for public view
 |  | from | 113 |  |  |
| | | from | 113 | | |
Abstract
Necrotizing enterocolitis is the most serious gastrointestinal disorder that occurs in the neonatal period and affects premature sick infants mostly.
The incidence of NEC varies but stated most often as from 1-7% of neonatal intensive care admissions and from 1-3% 1000 live births, premature infants account for about 70%- 90% of NEC cases.
Prematurity is considered as an important risk factor for NEC. The disease is likely related to an immature gastrointestinal mucosal barrier and immune response, along with impaired circulatory dynamics from hypoxic-ischemic insults.
Clinical diagnosis of NEC depends on proper detection of poor tolerance to feeding, abdominal distention, and bile stained vomitus. Investigations should be carried on immediately to find the characteristic picture of NEC either laboratory or radiologically.
Treatment of NEC should be undertaken as soon as NEC was suspected, early bowel decompression with broad spectrum antibiotics together with intravascular volume maintenance are the main lines for therapy, in severe cases intubations and mechanical ventilation are necessary.
Surgical management is indicated with development of bowl perforation or if progressive clinical deterioration occurs.
The goal of any surgical procedure for the treatment of NEC was to remove the entire necrotic bowel and to preserve as much bowel length as possible. The most widely accepted procedure to accomplish this goal is laparotomy with resection of gangrenous intestine and exteriorization of all viable ends as stomas and there are other variable surgical procedures for treatment of this disease.
The mortality rate of NEC ranges from 10-44% in very low birth weight infants, and it is about 20% of infants with birth weight more than 2500 g.
Finally all interventions side by side with studies should be done and continued to decrease the incidence and the complications of this diseases considering the clear excellent results of early diagnosis and management in decreasing its occurrence.