Necrotizing Enterocolitis

Inflammatory bowel disease of premature infants. Bell staging guides management.

Educational decision support · Not a medical device · Do not enter PHI

Key points

Triad: feeding intolerance, abdominal distension, bloody stools.
X-ray: pneumatosis intestinalis, portal venous gas, free air.
NPO, OG decompression, broad-spectrum antibiotics, surgical consult if perforation.

Pitfalls

Pneumoperitoneum may not always be visible — get cross-table lateral.
Watch for evolving sepsis and DIC.

Ask the Copilot

— Walk me through Bell staging.
— When is surgery indicated in NEC?