Necrotizing enterocolitis in a moderately preterm neonate in the first week of life: A case report

Necrotizing enterocolitis, a life-threatening surgical condition, is uncommon in the first week of life in preterm neonates. However, the certainty of the risk factors contributing to NEC in preterm neonates during the first week of life remains ambiguous. Our case was amoderately preterm, small for gestation at birth, and delivered by emergency Caesarean section for maternal respiratory distress. In the background of growth restriction and perinatal asphyxia, this neonate deteriorated at 90 h of life and developed feed intolerance, abdominal distension, and haemodynamic compromise. Abdominal radiography demonstrated pneumatosis intestinalis suggestive of necrotizing enterocolitis. The child subsequently succumbed at 110 h of life, possibly to catecholamine-resistant septic shock secondary to multidrug-resistant Klebsiella pneumonia. In the background of conditions causing gut ischaemia, bacterial sepsis may have set off an inflammatory cascade that led to necrotizing enterocolitis at a younger age than usual described in the literature.