Etiopathogenic and prognostic features of necrotizing enterocolitis in neonates from twin pregnancy - case report

Abstract

This article presents the case of a premature newborn from a twin pregnancy who developed necrotizing enterocolitis (NEC). There are some issues about NEC ethiopatogeny that must be understood within the first day of a newborn’s life. NEC is an inflammatory disease of multifactorial etiology, incompletely understood, characterised by variable damage of the intestinal wall, starting with the injury of intestinal mucosa and continuing with necrosis and perforation of all the intestinal layers. Ischaemia or reperfusion of immature bowel lead to bacterial invasion of the wall layers. Furthermore, bacteria start an inflammatory process which leads to local destruction, intestinal perforation and sepsis. NEC is typically developed in small for gestation age preterm and very low birth weight babies, but it can also occur in near term or in term babies. Even though a lot of progress has been made in the NICU technology, NEC still has an increasing incidence, with a high rate of morbidity and mortality. If diagnosed early, a loc of NEC cases respond to specific medical treatment; however, most of them become surgical emergencies which require high costs. The survival rate of surgical treated patients can reach up to 95%, although the incidence of complications such as stenosis or short bowel syndrome remains high. Knowing the risk factors which lead to NEC can lead to early NEC diagnosis and choosing the right treatment. Strategies of decreasing risk factors (antenatal corticosteroids, breastfeeding, standardised feeding guidelines, probiotics) can contribute to lower the NEC incidence in preterm babies.