Necrotising enterocolitis staging

Necrotising enterocolitis (NEC) can be staged into three groups, helping to guide appropriate treatment. In general stage I and II are managed medically, whereas stage III is managed surgically.

  • stage I
    • clinical signs
      • lethargy, temperature instability, apnoea, bradycardia
      • emesis, abdominal distension, haematochezia
    • radiographic findings
      • intenstinal dilation
    • treatment
      • oral feeding cessation
      • parenteral nutrition
      • NGT suction
      • antibiotics
  • stage II
    • IIa: mildly ill
    • IIb: moderately ill
    • clinical signs
      • as in stage I
      • metabolic acidosis, thrombocytopaenia
      • abdominal tenderness, absent bowel signs
    • radiographic findings
    • treatment
      • as in stage I
      • correction of metabolic acidosis
  • stage IIIa: shock
    • clinical signs
      • as in stage II
      • respiratory or circulatory arrest
    • radiographic findings
      • as in stage II
      • ascites
    • treatment
      • inotropes etc...
      • as in stage II
  • stage IIIb: perforation
    • clinical signs: any
    • radiographic findings: pneumoperitoneum
    • treatment: surgery

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