Small intestine & ampulla
Inflammatory disorders
Necrotizing enterocolitis
Author: Hanni Gulwani, M.B.B.S.
Last author update: 1 August 2012
Last staff update: 3 November 2023
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: Necrotizing enterocolitis
Table of Contents
Definition / general | Etiology | Diagrams / tables | Clinical features | Treatment | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Additional referencesCite this page: Gulwani H. Necrotizing enterocolitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/smallbowelnecrotizingent.html. Accessed May 6th, 2024.
Definition / general
- Acute, necrotizing inflammation of small bowel and colon in patients with myelosuppression
- Also called typhlitis, neutropenic enterocolitis, ileocecal syndrome
- Most common acquired GI emergency of neonates (eMedicine: Necrotizing Enterocolitis [Accessed 13 February 2018])
- Common in premature or low birth weight infants, particularly when they start on oral foods at 2 - 4 days
- Also adults with various myeloproliferative disorders, solid malignancies, posttransplant immunosuppression (eMedicine: Neutropenic Enterocolitis [Accessed 13 February 2018])
- Affects terminal ileum, ascending colon
Etiology
- Intestinal bacteria invade immature intestinal epithelium, causing subsequent inflammation and tissue necrosis
- Bacteria in food produce more cytokines and injure mucosa
- May be due to TNF receptor 1 dependent depletion of mucus which occurs in immature small intestine (Am J Physiol Gastrointest Liver Physiol 2011;301:G656)
- May also be due to deranged intestinal blood flow (J Pediatr Surg 2011;46:1023)
Diagrams / tables
Images hosted on other servers:
TLR4 signaling in pathogenesis of necrotizing enterocolitis
Clinical features
- Symptoms: mild GI disturbance or fulminant illness with intestinal gangrene, perforation, sepsis, shock
- Complications: short bowel syndrome, malabsorption (due to ileal resection), strictures, recurrence
Treatment
- Fluids and surgery if gangrene / perforation
Gross images
Images hosted on other servers:
Various images
Microscopic (histologic) description
- Early: mucosal edema, hemorrhage, necrosis
- Late: hemorrhagic and gangrenous bowel wall, fibrous strictures; often pneumatosis cystoides intestinalis
- After recovery, Paneth cell hyperplasia; colon also shows metaplastic Paneth cells (Pediatr Res 2011;69:217)
Microscopic (histologic) images
Images hosted on other servers:
Various images
Additional references
