Colon non tumor
Colitis (non-infectious)
Necrotizing enterocolitis

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 27 December 2016, last major update May 2013

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: necrotizing enterocolitis [title] colon
Cite this page: Necrotizing enterocolitis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/colonNEC.html. Accessed August 18th, 2017.
Definition / general
Etiology
  • Oral feeding of neonates with immature gut immune system causes release of proinflammatory cytokines; bacteria in food produce more cytokines which injure mucosa; intestinal blood flow may be disturbed
  • IL10 may prevent by attenuating intestinal inflammation (Am J Surg 2012;203:428)
Clinical features
  • Symptoms: abdominal distention, loss of bowel sounds, blood-stained stool
  • Complications: bowel perforation, short bowel syndrome, malabsorption (due to ileal resection), strictures, recurrence
Treatment
  • Fluids and surgery if gangrene/perforation
Gross description
  • Necrotic mucosa, submucosal gas-filled cysts
Gross images

Images hosted on Pathout server:

In situ

Thickened wall, mucosal ulceration, cyst-like spaces

Transverse section shows cyst-like spaces in wall

Alimentary tract

Small intestine

Microscopic (histologic) description
  • Early: mucosal edema, hemorrhage, necrosis, pneumatosis cystoides intestinalis
  • Late: hemorrhagic and gangrenous bowel wall with strictures
Microscopic (histologic) images

Images hosted on Pathout server:
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Hemorrhagic necrosis

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Mucosal necrosis and cyst-like spaces in submucosa

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Submucosal cyst-like spaces #1

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#2 lined by flattened cells

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Subserosal lymph node with cyst-like spaces

Differential diagnosis