ABSTRACT
Necrotizing enterocolitis (NEC) is a life-threatening disease of the gastrointestinal tract that primarily affects premature neonates. Infants with NEC experience a high risk for increased morbidity and mortality, thus indicating a need to implement early medical management to minimize the progression to advanced stages of disease. The objective of this chapter is to discuss the initial clinical approach to an infant with NEC, including strategies for bowel rest and the use of serial abdominal radiographs to monitor for pathognomonic features of NEC. Additionally, this chapter will provide an overview of the evidence for antibiotic choice in the treatment of NEC. We then discuss the evaluation and management of common hematologic abnormalities seen during NEC, such as anemia, thrombocytopenia, and coagulopathy. Lastly, we describe complications that can occur despite appropriate NEC management, including multiorgan compromise, short bowel syndrome, intestinal strictures, and NEC recurrence.
