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NEC is a serious condition that occurs most often in preterm and very immature neonates; it develops in about 5 per cent of all neonates in neonatal intensive care units. The exact cause of the condition is not known, but it is related to ischemia or poor perfusion of blood vessels in sections of the bowel. The ischemia is thought to occur when an earlier oxygen depletion in the heart and brain, as in anoxia or shock, causes blood to be shunted away from less vital organs such as the intestine.
Since the incidence of NEC is low in neonates who are breast-fed, it is likely that the necrotizing process is initiated by a response to the protein in cow's milk and the profuse multiplication of bacteria that thrive more readily in cow's milk than in breast milk. The gas-forming bacteria invade the damaged intestinal cells, causing them to rupture and producing pneumatosis intestinalis, that is, the presence of air in the submucosal or subserosal surfaces of the colon.
Abdominal x-rays will show a characteristic invasion of air in the intestinal wall. If perforation has occurred, the x-ray will reveal free air in the abdominal cavity. Nonspecific symptoms of NEC usually appear in the first week of life and may be overlooked when caregivers are preoccupied with more obvious life-threatening problems. Typically, the neonate exhibits lethargy, vomiting, distended abdomen, signs of intestinal bleeding, and absence of bowel sounds.
Once the condition is diagnosed, all oral feedings are stopped to rest the intestinal tract. Feeding must then be accomplished intravenously. Gastrointestinal decompression via nasogastric suction may be instituted to relieve distention, and antibiotics administered to limit secondary bacterial infection. Progressive deterioration or evidence of perforation are indications for surgery to remove the diseased portion of the bowel. If damage is extensive an ileostomy or colostomy may be necessary.
necrotizing/nec·ro·tiz·ing/ (nek´ro-tīz″ing) causing necrosis.
Patient discussion about necrotizing
Q. can necrosis in a brain tumor kill you? If so, how? husband has glioblastoma.Tumor seems under control at this point as much as they can tell but sounds like there is a lot of necrosis. He has lots of tumor progression symptoms but since he has had the tumor for so long == 6 years = I guess the necrosis is there moreso than the actual tumor == how dangerous can this be?