What Is Necrotizing Enterocolitis and How Can It Be Misdiagnosed?

A birth should be a joyous time for expecting parents and their entire family. Unfortunately, complications can occur during pregnancy or delivery. When a physician or other health professional fails to diagnose a potentially dangerous condition in a newborn, the consequences can be severe. One of these instances applies to necrotizing enterocolitis, a condition primarily affecting premature babies.

Necrotizing enterocolitis is a rare but devastating disease that primarily affects premature infants, but can affect any newborn within the first two weeks of birth. It occurs when bacteria invades the intestine and begins a process of local infection and degradation of the delicate, still developing intestinal tissue. Left untreated, it can lead to the destruction of the bowel wall and spillage of the contents of the intestine into the abdomen, leading to systemic infection and death.

Necrotizing Enterocolitis, or NEC, affects only 1 in 2000-4000 births and makes up about 1% of neonatal intensive care (NICU) admissions. It may occur in up to 10% of all premature infants but is extremely rare in full term babies. The exact reason for this disease onset is unknown, but several theories exist regarding why it may affect premature babies. Neonates before 37 weeks gestation have especially immature lungs and immature digestive tissue. As a result, not as much oxygen gets to the intestines, which can lead to necrosis (cell death). Additional research suggests that formula fed infants are more likely to experience NEC, suggesting that an immature immune system may also play a role.

NEC presents within the first two weeks of life, most commonly in a premature baby who is formula fed. One of the earliest signs of the disease is an inability to tolerate feedings. The baby may also present with abdominal bloating or vomiting green-colored bile. From there, the disease progresses and may present with the following symptoms:

If a medical team catches the disease quickly enough, many babies can recover from NEC without the need for surgery. Treatment for NEC may include

Diagnosing NEC requires a full physical examination which may include the following:

When a baby presents with any of the symptoms above and a doctor fails to correctly diagnose the issue by ordering these tests, he or she may have committed negligence. Parents of children with NEC may also have grounds for a medical malpractice claim if their child’s provider failed to provide care in line with the standard of practice within the medical community. Proving this requires testimony from a similarly trained medical professional with similar background and experience.

Most babies who receive a speedy diagnosis of NEC make a full recovery. However, this disease presents a serious threat and time is of the essence. A misdiagnosis can lead to permanent injury.

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