Table 1: Clinical findings of NEC (Modified Bell Classification).

(I) “Suspected” NEC:
 (i) Temperature instability, apnoea, bradycardia, lethargy
 (ii) Gastric retention, abdominal distention, emesis, blood in stool
 (iii) Normal or intestinal dilation and mild ileus on abdominal radiograph

(II) “Definite” NEC:
 (i) As above plus
 (ii) Absent bowel sounds ± abdominal tenderness ± abdominal cellulitis or right lower quadrant mass
 (iii) Radiological evidence of intestinal dilation, ileus, or pneumatosis intestinalis ± ascites

(III) “Advanced” NEC:
 (i) As above plus
 (ii) Hypotension, bradycardia, severe apnoea, respiratory and metabolic acidosis, coagulopathy, or neutropaenia
  (iii) Signs of peritonitis, marked tenderness, and abdominal distention ± radiological evidence
  of intestinal perforation (pneumoperitoneum)