[The etiology of necrotizing enterocolitis in the newborn]

Apparently there are different causes for necrotizing enterocolitis (NEC) in the newborn infant. Besides it may be that NEC only is caused by the interaction of several factors such as perinatal complications, medical measures, an aggressive oral alimentation and an adverse colonization of the bowel and that a critical degree of stress is required to initiate enterocolitis. This assumption would help to explain, why one newborn infant can stand an episode of perinatal stress without falling ill, while the other develops the disease a short time later. Probably NEC starts with an intestinal mucosa damage caused by ischemia or local noxae, and only subsequent invasion by the bowel flora into the damaged tissue and gas formation within the bowel wall lead to the picture of necrotizing inflammation and pneumatosis intestinalis.