Necrotizing Enterocolitis – Top USMLE Diseases

Necrotizing enterocolitis (NEC) is an intestinal inflammatory process that can lead to mucosal injury and necrosis. The condition is multifactorial, with underlying risk factors that include prematurity and formula feeding. The clinical presentation varies in severity from feeding intolerance, acute findings on abdominal exam, and systemic symptoms. The diagnosis is based on a clinical suspicion, abnormal abdominal radiographs, and supporting abnormal laboratory results. Management consists of supportive medical care for milder stages and bowel rest and surgical intervention for more advanced stages. Necrotizing enterocolitis and its complications carry a high risk of morbidity and mortality.

Apnea of prematurity is a condition that is believed to be caused by the immaturity of the respiratory center in the brainstem of premature babies and is characterized by periods of apnea that are longer than 20 seconds. Apnea that is less than 20 seconds but associated with significant bradycardia and/or oxygen desaturation can be also considered as apnea of prematurity. A full diagnostic workup to exclude sepsis, seizures, intracranial hemorrhage and other causes of apnea should be performed. Tactile stimulation is usually sufficient for mild apnea. Oxygen supplementation might be needed in moderate cases of apnea while medical treatment should be provided to severe cases.