New concepts in necrotizing enterocolitis

Necrotizing enterocolitis is an overwhelming gastrointestinal emergency tha t primarily afflicts premature infants born weighing less than 1500 g, Desp ite years of investigation, the etiology remains unclear, and accepted prev ention and treatment strategies are lacking. Studies published over the las t year have provided new insight into several aspects of this complex disea se. In this review, novel information is presented on (1) the epidemiology; (2) methods of early diagnosis, such as abdominal magnetic resonance imagi ng; (3) the importance of risk factors, including assessment of feeding str ategies and role of bacterial colonization; (4) the pathophysiology, highli ghting experimental and clinical trials evaluating the role of inflammatory mediators and growth factors on the disease; (5) preventive strategies, su ch as anaerobic bacterial supplementation; and (6) surgical interventions, including peritoneal drainage. Understanding some of these important aspect s of necrotizing enterocolitis may help improve the outlook of patients wit h this dreaded disease. Although the incidence of neonatal necrotizing ente rocolitis (NEC) and the mortality stemming from this disease have not signi ficantly improved over the last 30 years, there is exciting new information that may significantly improve the outlook of patients with this overwhelm ing intestinal emergency in the near future. (C) 2001 Lippincott Williams & Wilkins, Inc.