Necrotizing Enterocolitis

Jacob Olson, MD, Gail Besner, MD, John HT Waldhausen, MD, David M. Powell, MD, Ronald B Hirschl, MD
Author Names: Jacob Olson, MD, Gail Besner, MD, John HT Waldhausen, MD, David M. Powell, MD, Ronald B Hirschl, MD

Introduction

necrotizing enterocolitis
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Necrotizing enterocolitis (NEC) is the most common newborn surgical emergency and the leading surgical cause of mortality and morbidity in the neonatal intensive care unit. NEC is typically a disease of premature infants even though it can also be seen in term neonates. Pediatric surgeons are routinely asked to assess and treat increasing numbers of these patients. Non-operative management is the initial approach with surgical intervention reserved for the treatment of the complications of the disease. A universal optimal surgical strategy for NEC remains elusive despite decades of experience with this disorder. However, the overall body of knowledge regarding NEC confirms that early detection and initiation of nonoperative therapy is key and can prevent the progression of the disease such that it will not require surgical intervention.

Opportunities exist in improving our prevention and treatment of NEC as well as elucidating its complex pathophysiology [1]. Pediatric surgeons can play an active role in directing the care of these patients even in the medical management stages.

Approximately 4500 hospitalizations occur each year due to NEC. The average length of stay at the hospital for NEC-affected infants is 50 days. The neonates with medical NEC on average spend 20 days more in the neonatal ICU than unaffected ones, the ones requiring surgery spend over 60days longer. NEC accounts for a large portion of the financial burden associated with preterm birth; indeed, the average total treatment cost per patient is estimated to be $500,000, with the total cost per year in the United States estimated between $500 million and $1 billion.

see also Spontaneous Intestinal Perforation and Necrotizing Enterocolitis Exploration

Content in this topic is referenced in SCORE Necrotizing Enterocolitis overview

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Last updated: February 1, 2026