Prevention and Treatment of Necrotizing Enterocolitis

Byong Sop Lee

doi:10.7599/hmr.2009.29.4.346

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Lee: Prevention and Treatment of Necrotizing Enterocolitis

Review Article

Hanyang Medical Reviews 2009; 29(4): 346-353.

Published online: 30 November 2009

DOI: https://doi.org/10.7599/hmr.2009.29.4.346

Prevention and Treatment of Necrotizing Enterocolitis

Byong Sop Lee, M.D.

Department of Pediatrics, College of Medicine, Ulsan University, Seoul, Korea.

Corresponding author (mdleebs@amc.seoul.kr)

Received 25 August 2009 Accepted 14 September 2009

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Necrotizing enterocolitis (NEC) is a leading cause of morbidity and mortality among premature infants. Although the pathogenesis of NEC remains unclear, recent researches revealed several associated factors of the immature intestine, with an emphasis of delayed maturation of motor and digestive function, impairment of regulation of vascular flow and intestinal barrier function, and defective immune defense. Many clinical trials have investigated the preventive role of possible disease-modification factors, but only breast feeding and antenatal steroid were proven to decrease the incidence of NEC in meta-analyses. Recent multicenter studies demonstrated a promising outcome of probiotics supplementation in the prevention of NEC, which emphasized the role of abnormal bacterial colonization in the pathogenesis of NEC. Studies on optimal choice for surgically indicated infants with NEC (laparatomy versus primary peritoneal drainage) still remain inconclusive. As NEC is a disease with a multifactorial etiology, combinations of current evidence in practice are required to reduce the incidence of NEC.

Keywords: Necrotizing enterocolitis, Probiotics, Laparatomy, Peritoneal drainage

Figures and Tables

Table 1

Treatment according to the classification of necrotizing enterocolitis (Modified Bell's Staging Criteria).

References

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