Necrotising enterocolitis (NEC) is a serious bowel condition which, according to Great Ormond Street Hospital, is the most common surgical emergency in newborns. It particularly affects premature or ill babies.
What is NEC?
NEC occurs when tissues in the bowel become inflamed and start to die. This is known as necrosis. If a hole develops in the damaged tissue, the contents of the gut can leak into the baby’s abdominal cavity, causing life-threatening infection.
What are the symptoms of NEC?
Symptoms of NEC include:
- problems with feeding
- swollen or tender abdomen (tummy)
- blood in the baby’s poo
- vomiting (in particular vomiting bile, a dark green or yellow fluid)
- low blood pressure
NEC can be difficult to diagnose as many of the symptoms are seen in other conditions that affect premature or poorly babies, and babies with NEC can deteriorate very quickly.
How is NEC treated?
The first line of treatment is usually to rest the baby’s bowel by stopping milk feeds. A tube may be used to drain the contents of the baby’s stomach. Fluids, nutrients and medicines, including drugs to raise the blood pressure and antibiotics, can be given intravenously (through the baby’s veins).
However, if the baby’s condition continues to deteriorate, or if there is evidence of a perforation in the bowel, an operation will be required under general anaesthetic to remove the damaged part of the bowel.
What are the longer-term consequences of NEC?
In cases where NEC is successfully treated without surgery, the outlook for babies affected is usually very positive.
Where surgery is required, the outcome will often depend on the amount of bowel that has been removed, which is why early diagnosis and treatment is very important.
There are risks associated with surgery, particularly in very small and poorly babies. Sadly, many babies who have surgery for NEC do not survive.
If the surgeons are unable to join the undamaged sections of the bowel back together, they will create an opening through the skin of the abdomen called a stoma, which will allow the baby to continue to pass waste. This can usually be reversed once the bowel has had time to heal, but in rare cases it has to be permanent.
Children who have had a large section of bowel removed may suffer from a condition called short bowel syndrome, which makes it difficult to absorb enough fluids and nutrients.
How can I find out more about NEC?
If you are looking for additional information and support on NEC, there are a number of organisations and resources that may be useful to you:
If you are concerned that you or your newborn baby has received substandard care as a result of medical negligence, it’s important to seek legal advice. If negligence can be proven, you may be able to make a claim for compensation.