Small intestine & ampulla

Inflammatory disorders

Necrotizing enterocolitis

Topic Completed: 1 August 2012

Minor changes: 19 November 2020

Copyright: 2003-2021,, Inc.

PubMed Search: Necrotizing enterocolitis[TI] small bowel[TIAB]

Hanni Gulwani, M.B.B.S.
Page views in 2020: 3,580
Page views in 2021 to date: 3,796
Cite this page: Gulwani H. Necrotizing enterocolitis. website. Accessed December 6th, 2021.
Definition / general
  • 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
  • Fluids and surgery if gangrene / perforation
Clinical images

Images hosted on other servers:

Intraoperative (Figure 25b)

Gross images

Images hosted on other servers:

Various images

Various images (Figure 1c)

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

Back to top
Image 01 Image 02