This document discusses necrotizing enterocolitis (NEC), a life-threatening condition that affects premature infants. It causes necrosis of the intestinal wall. Risk factors include perinatal asphyxia, low Apgar scores, respiratory distress syndrome, congenital heart disease, and sepsis. The pathophysiology involves hypoxia, acidosis, hypoglycemia, decreased blood flow to the intestines, and invasion of the intestines by bacteria like E. coli and Klebsiella. Clinical presentation includes abdominal distension and bloody stools. Diagnosis involves blood tests, stool and abdominal imaging. Treatment consists of discontinuing oral feeding, IV fluids, antibiotics, and supportive care. Prevention focuses on exclusively feeding preterm

1. NECROTIZING ENTEROCOLITIS
PRESENTED BY,
MS. L.SOUNDARYA
M.SC.NURSING (PEDIATRICS)

4. • NEC characterized by necrosis of the intestinal
wall, is a serious life threatening condition that is
being diagnosed with increasing frequency in
premature infants

7. ETIOLOGY

8. • Perinatal asphyxia
• Low apgar score
• IRDS
• Congenital heart disease
• sepsis

9. • Ischemia/hypovolemia of the
intestinal tract that is associated
with; Hypotension
Use of umbilical catheters
Exchange transfusion
hypertonic foods
Medications or fliuds

10. PATHOPHYSIOLOGY

11. Hypoxia, acidosis, hypoglycemia, low cardiac
output, hypothermia
Decreased splanchnic blood flow
Hypertonic feeding –mucosal edema, ulceration
Intestinal colonization with E.Coli, Klebshella
Invasive infection by bowel flora

12. Bacterial invasion of portal system and lymphatic
bowels
Transdural bowel
necrosis
Perforation
Collapse
Sepsis
Endotoxin release
Pneumotosis
intestinalis
Portal gas, septicemia

13. CLINICAL PRESENTATION

15. DIAGNOSTIC EVALUATION

16. • History collection
• Physical examination
• Blood test- bilirubin, serum electrolytes ,
blood sugar level, blood culture
• Stool culture/ sensitivity
• Abdominal x-ray/ USG
• Hepatic ultrasonography

18. NURSING MANAGEMENT

19. Oral feeding should be discontinued
peripheral IV fluids can be started
NG tube –to remove stomach contents
Antibiotic therapy
Psychosocial support
Hydrocorticosone may be given
Regular check up of vital signs
Prevent cross infection.

20. Outcomes
• Re-occurance of the disease
• PREVENTION
Fresh breast milk feeding to all
neonates