Abstract
Necrotizing enterocolitis (NEC) is a neonatal surgical emergency with potentially devastating consequences. Pre-term infants of very low birth weight are most at risk with several genetic and environmental risk factors identified. The local microbial environment plays a key role in early life to help reduce the risk of NEC. Breast milk has also shown to be protective. The disease is characterized by infection, inflammation, and ischaemia of the bowel affecting focal, segmental, or the entire length of bowel. The diagnosis is made clinically with the support of biochemical and radiological features. Emerging new biomarkers are being used to identify patients at risk. Bowel perforation is the most widely accepted indication for surgery. However, when conservative management fails, surgery is indicated with the aim of resecting necrotic bowel and preserving intestinal length. Complications of NEC include strictures, stoma morbidity, short-bowel syndrome and poor neurodevelopmental outcomes. Preventative strategies include early suspicion and appropriate management, as well as encouraging the use of breast milk. The use of probiotics is controversial, but has gained support for usage.
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