Noninfectious colitis

Necrotizing enterocolitis

Topic Completed: 1 May 2013

Minor changes: 30 September 2020

Copyright: 2003-2021,, Inc.

PubMed Search: necrotizing enterocolitis [title] colon

Hanni Gulwani, M.B.B.S.
Page views in 2020: 1,033
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Cite this page: Gulwani H. Necrotizing enterocolitis. website. Accessed October 28th, 2021.
Definition / general
  • 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
  • Fluids and surgery if gangrene/perforation
Gross description
  • Necrotic mucosa, submucosal gas-filled cysts
Gross images

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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

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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

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Lined by flattened cells

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Subserosal lymph node with cyst-like spaces

Differential diagnosis
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