Necrotizing Enterocolitis in Very Low Birth Weight Infants: A Systemic Review

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)