Necrotizing enterocolitis (NEC)

 Necrotizing Enterocolitis (NEC) in Sheikh Shakhbout Medical City

Necrotizing Enterocolitis (NEC)

Necrotizing enterocolitis (NEC) is a severe gastrointestinal condition primarily affecting neonates, particularly premature infants. This life-threatening illness is characterized by inflammation of the intestinal wall, leading to bacterial invasion, cellular damage, and necrosis. The mortality rate for NEC can be alarmingly high, reaching up to 50% in affected populations

Pathophysiology of NEC

The pathophysiology of NEC involves a complex interplay of factors that result in intestinal inflammation and necrosis. Initially, the intestinal wall becomes inflamed, allowing bacteria to invade the tissue. As the condition progresses, it can lead to complications such as intestinal perforation, which can cause peritonitis and sepsis—both of which are critical medical emergencies

Symptoms and Diagnosis

Common Symptoms:

• Poor feeding
• Vomiting
• Lethargy
• Abdominal tenderness

These symptoms are often nonspecific, making early recognition crucial for effective management. Clinicians must maintain a high index of suspicion when these signs present in neonates Diagnostic Procedures: The primary diagnostic tool for NEC is an abdominal X-ray, which may reveal dilated loops of bowel and signs of pneumatosis intestinalis—air within the intestinal wall, indicative of disease progression

Treatment Protocols at Sheikh Shakhbout Medical City

At Sheikh Shakhbout Medical City (SSMC), a multidisciplinary approach is employed to manage NEC effectively. The treatment protocol includes:

1. Immediate Cessation of Enteral Feedings: Patients are kept NPO (nil per os) to prevent further irritation of the intestines.
2. Gastric Decompression: A nasogastric tube is inserted to relieve abdominal distension.
3. Intravenous Antibiotics: Broad-spectrum antibiotics such as ampicillin and gentamicin are administered to combat infection.
4. Nutritional Support: Total parenteral nutrition (TPN) is provided to ensure adequate nutritional intake while the gastrointestinal system is at rest.

If conservative management proves successful, enteral feeding may be cautiously resumed once clinical signs improve

The Role of Pediatric Surgery and Urology at SSMC

The Division of Pediatric Surgery and Pediatric Urology at SSMC specializes in advanced surgical interventions for conditions like NEC. The team comprises highly trained pediatric surgeons who utilize state-of-the-art technology and minimally invasive techniques to enhance patient outcomes. Early surgical intervention may be necessary in cases where conservative treatments fail or if there is significant bowel perforation Sheikh Shakhbout Medical City stands at the forefront of pediatric healthcare, providing comprehensive care for conditions such as necrotizing enterocolitis. With a focus on individualized treatment plans and a commitment to excellence in pediatric surgery and urology, SSMC aims to improve survival rates and long-term outcomes for neonates affected by this serious condition. Through collaborative efforts among healthcare professionals, SSMC continues to set new benchmarks in the management of complex pediatric illnesses.  

Why choose SSMC?

The Division of Paediatric Surgery & Paediatric Urology at Sheikh Shakhbout Medical City (SSMC), Abu Dhabi, hosts a multidisciplinary team comprising American and British board-certified surgeons equipped with the expertise to treat and manage a broad spectrum of paediatric surgical and urological conditions. State-of-the-art paediatric operating rooms, alongside advanced minimally invasive suites, provide the perfect atmosphere for optimal surgical care of our paediatric and neonatal patients. They are equipped with highly advanced, high-definition imaging technology, advanced image capture and routing capabilities in an ergonomically efficient environment. SSMC offers one of the region’s most advanced Neonatal & Paediatric Intensive Care units, with a highly qualified team of health professionals capable of providing premium quality care. Our paediatrics surgeons provide a range of surgical and urological services using minimally invasive approaches, including:

• General paediatric surgery
• Hepatobiliary paediatric surgery
• Pancreatic surgery
• Hernia repair
• Paediatric thoracic surgery, including video-assisted thoracoscopic surgery (VATS)
• Neonatal surgery
• Paediatric urology
• Diagnostic and therapeutic upper and lower gastrointestinal endoscopies (procedure to view the body internally)
• Diagnostic and therapeutic bronchoscopies (inspection of the lungs and air passages)
• Paediatric vascular access
• Appendectomy (removal of the appendix)
• Fundoplication (surgery to treat stomach acid reflux)
• Ureteric reimplantation (surgery of the ureters)
• Lung resections (partial or full removal of the lung)
• Pyeloplasty (surgical reconstruction of the kidney)
• Endourology (inspection and surgery of the urinary tract)

As we continue to strive to provide the best of care to our patients, our paediatric surgical team works closely in a multidisciplinary approach with other divisions, including Paediatrics, Neonatology, Radiology, and other relevant departments, to provide nationally and regionally renowned care in the management of complex paediatrics surgical conditions.