Necrotizing Enterocolitis (NEC): Other FAQs

There are common questions that we can answer about all health topics, such as "What is it?" and "How many people are affected." Answers to these questions are found under Condition Information. Each health topic frequently has specific questions that pertain only to that topic. We have answered those in this section.

Are there disorders or conditions associated with necrotizing enterocolitis?

In full-term infants more often than in preterm infants, necrotizing enterocolitis (NEC) is associated with congenital heart disease. Some researchers consider this type of NEC to be different from other types because infants who have NEC along with congenital heart disease have less of a chance of developing a hole in their intestine, which would require surgery. Thus the name “cardiogenic necrotizing enterocolitis,” or NEC that stems from heart problems, has been suggested for this disease.¹

Other conditions that can predispose a full-term infant to NEC include severe asphyxia (lack of oxygen) suffered before, during, or immediately after birth and a condition known as polycythemia, in which the infant has higher than normal amount of red blood cells expressed as “hematocrit.” Healthy infants have a hematocrit value between 45% and 65%. In infants with polycythemia, the hematocrit value is higher than 65%. Bursting of the intestine, which leads to a hole in its wall (called a perforation), as a result of infection and local tissue damage is the most serious complication of NEC. Removing the severely damaged or dead segment of the intestine is a major surgical procedure. Surgeons will hook the cut ends of the intestines to the abdominal wall until all signs of intestinal infection are healed. Later, in a second surgical procedure, the intestines are reconnected.²

Areas of the intestine that were damaged from NEC may develop scar tissue, known as stricture. This can cause the intestine to narrow, making it difficult for bowel contents to pass through. Dilation or surgery of the intestine may be necessary.

A serious residual complication of removing dead and damaged intestine is called “short-gut syndrome.” This syndrome causes problems with digestion if long portions of the small intestine that absorb nutrition have been removed. As the child gets older (over a span of 2 to 3 years), this digestive problem may improve. If it does not, it can cause under-nutrition, requiring prolonged nutritional support using intravenous routes. The latter can lead to liver failure. If the digestive problems do not resolve, infants with this complication may need a liver transplant and/or a small-bowel transplant.³

Other possible complications of NEC include²:

• Partial or complete blockage of the intestine due to abnormal tissue growth or scar tissue.
• Infection of the tissue lining the stomach (called peritonitis) [pronounced per-i-tn-AHY-tis].
• Sepsis (pronounced SEP-sis), a severe reaction of the child’s body to infection.

1. Pickard, S. S., Feinstein, J. A., Popat, R. A., Huang, L., & Dutta, S. (2009). Short- and long-term outcomes of necrotizing enterocolitis in infants with congenital heart disease. Pediatrics, 123, e901–e906. [top]
2. U.S. National Library of Medicine. (2011). Necrotizing enterocolitis. Retrieved August 2, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002133 [top]
3. Medscape. (2012). Necrotizing enterocolitis. Retrieved August 2, 2012, from http://emedicine.medscape.com/article/977956-overview#aw2aab6b2b4 [top]