[Neonatal necrotizing enterocolitis]

Necrotizing enterocolitis (NEC) is an extremely severe clinical entity in whose pathogenesis at least two of the following factors are involved: intestinal ischaemia, pathogenic bacterial colonization and excessive substrate in the intestinal contents. Common risk factors are prematurity, rapid increase of feeding volume, polycythemia and perinatal asphyxia. Clinical features are abdominal distention, gastric retention, bloody stools and intestinal wall pneumatosis; while its complications are bowel perforation, peritonitis and shock. Early diagnosis allows prompt medical treatment based upon intestinal rest, no oral feeding, parenteral hydration and nutrition, nasogastric intubation, broad spectrum antibiotics and close surveillance. Surgery is kept to treat complications. Prevention includes feeding with human milk in prematures with slow increase of partial and total volumes, early initial fastening in cases of asphyxia and careful and close surveillance of high-risk newborns.