NECROTISING ENTEROCOLITIS (Robbins pp 809)

Most common in neonates, and is marked by severe inflammation and necrosis of the small + large intestine. Commonly occurs when oral foods introduced.

Pathogenesis:

1) Gut immune system not fully developed, hence vulnerable,

2) Oral feeding leads to cytokine release ≫ inflammation,

3) Oral feeding leads to gut colonization of bacteria ≫ cytokines ≫ inflammation,

4) direct mucosal injury,

5) ischaemia?

Macroscopy / Microscopy: Affects terminal ileum + colon. Microscopically, four things are seen: 1) mucosal oedema, 2) haemorrhage, 3) necrosis, 4) gangrene.

Clinical features/Treatment: abdominal distension, sepsis, shock, faecal bleeding. Treatment is by fluid resuscitation + surgical resection of affected tissue.

Category: Pathology Notes