Necrotizing enterocolitis (staging)

Necrotizing enterocolitis (NEC) can be staged into three groups, to guide appropriate treatment based on the work of Bell et al. 1. In general, stage I and II are managed medically whereas stage III is managed surgically.

  • stage I
    • clinical signs
      • lethargy, temperature instability, apnea, bradycardia
      • emesis, abdominal distension, hematochezia
    • radiographic findings
      • intestinal dilatation
    • treatment
      • oral feeding cessation
      • parenteral nutrition
      • nasogastric tube suction
      • antibiotics
  • stage II
    • IIa: mildly ill
    • IIb: moderately ill
    • clinical signs
      • as in stage I
      • metabolic acidosis, thrombocytopenia
      • 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
    • treatment
      • inotropes, etc.
      • as in stage II
  • stage IIIb: perforation
    • clinical signs: any
    • radiographic findings: pneumoperitoneum
    • treatment: surgery
Share article

Article information

rID: 8456
Synonyms or Alternate Spellings:
  • Bell's staging of necrotizing enterocolitis
  • Bell's classification of necrotizing enterocolitis
  • Bell's criteria for necrotizing enterocolitis
  • Bell's staging of necrotising enterocolitis
  • Bell's classification of necrotising enterocolitis
  • Bell's criteria for necrotising enterocolitis
  • Staging of necrotising enterocolitis
  • Necrotizing enterocolitis staging
  • Staging of necrotizing enterocolitis

Support Radiopaedia and see fewer ads

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.