Carroll, Daniel (2025) Necrotizing enterocolitis: a review of current practice and current understanding of the pathophysiology. Paediatrics and Child Health, 36 (1). pp. 1-6.

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Abstract

Necrotizing enterocolitis (NEC) is the commonest life-threatening surgical emergency in neonates. Despite decades of study the mortality and morbidity associated with this condition remain stubbornly high and the incidence has not decreased despite the introduction of multiple strategies to prevent NEC. The pathophysiology is incompletely understood, but what we do understand is that prematurity resulting in an immature and gut with impaired innate immunity renders the neonatal gastrointestinal tract susceptible to abnormal bacterial colonization and a subsequent pathological inflammatory response resulting in localized tissue damage and cell death. Recent advances in the understanding of the disease have led to a plethora of new potential treatments to both prevent and treat this condition. Here we review the most recent trends in contemporary practice and provide a simple summary of the underlying pathogenesis. We will discuss what is known about the risk factors, clinical presentation, diagnosis and treatment of the condition, before moving on to strategies for prevention and long-term outcomes.

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