Hello and welcome to the Zero to Finals podcast. My name is Tom, and in this episode, I'm going to be

talking to you about necrotizing enterocolitis. And if you want to follow along with written notes on this topic,

you can follow along at zero tofinals.com slash NEC or in the neonatology section of the Zero to Finals pediatrics book. So let's get straight into it.

Necrotizing enterocolitis, often shortened to neck, NEC, is a disorder affecting premature

neonate where part of the bowel becomes necrotic. It's a life-threatening emergency.

Death of the bowel tissue can lead to bowel perforation, and bowel perforation leads to peritonitis and shock.

The cause of necrotizing enterocolitis is unclear. There are certain risk factors for developing necrotizing entrycolitis,

and these are a very low birth weight or very premature, formula feeds,

and we know it's less common in babies fed by breast milk feeds,

respiratory distress and assisted ventilation, sepsis, and patent ductus arteriosis or other congenital heart disease.

So how does it present?

Well, it presents in a premature neonate who becomes intolerant of feeds,

starts vomiting, particularly if it's green bile vomits.

Babies will look generally unwell.

There'll be a distended, tender abdomen,

absent bowel sounds on auscultation of the abdomen,

and blood in the stools.

When perforation occurs in the bowel,

there'll be peritonitis and shock,

and the neonate will be severely unwell.

There are a few investigations to consider.

Blood tests include a full blood count for thrombocytopinia and neutropenia,

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