Recovering the "lost thread” in the “skein” of necrotizing enterocolitis of newborns Narrative review

Abstract

Purpose of the review: The objective of this review is to delineate the pathophysiology of the classic Entero Necrotizing Colitis (NEC) of newborns, propose a list of perinatal antecedents that define a risk group, and establish simple and objective parameters that help to establish an early clinical diagnosis.

Recent findings: The mortality of the classic NEC of newborns is still high. Although the disease has several presentations, it is unique with a single installation route, and intestinal hypoperfusion is the initial offending agent.

Excerpt: The lack of prevention strategies and very late clinical diagnosis explain the high mortality of NEC. There is great confusion about the origin of the disease, implying that there are different types of NEC. Although the disease is unique, it has different manifestations according to the conditions of the newborn with a common route of installation, with intestinal hypoperfusion as an initial assailant agent. This article postulates that recognizing intestinal hypoperfusion as the initial offending agent is “finding the lost thread” that could help in developing prevention and treatment strategies, identifying patients at risk of NEC, and achieving a diagnosis early.