الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
The study included 70 cases with NEC 51case preterm and 19 case near & fullterm, 26 male and 44 female, their mean weight varied between 800<1500 gm. and1500-3500 gm. respectefly. They were admitted in NICU at Assuit university hospital during the period (June 2016 – July 2017).
All patients were subjected to full history taken including maternal history as (maternal hypertension, D.M, infection, PROM), neonatal history as (IUGR, neonatal sepsis, neonatal asphyxia, exchange transfusion), clinical examination was done including (Respiratory distress, jaundice, abdominal distention, abdominal wall erythema, vomiting, lethargy, irritability, Poor feeding, apnea, bleeding tendency). The investigations included laboratory as (CBC, renal function test, serum electrolyte, arterial blood gases, blood glucose level, CRP, blood culture), and radiological as (Abdominal ultrasound, abdominal plain erect). Guidelines for management including: Bowel rest, IV fluid and TPN, Bowel decompression (by NG tube), Correction of metabolic acidosis were done for 100% of cases. Triple antibiotic therapy for 14 days and 27.2% of all cases need Mechanical ventilation. Results: The present study showed higher rate of necrotizing enterocolitis in Preterm (72.9%) than near and full term (27.1 %).37 case preterm were 800<1500gm.weight at (75.6%) and 27.4% were1500-3500 gm., 10 cases near and full term were 800< 1500gm. at (52.6%) and 9 cases (1500-3500 gm.) at (47.4%).Regarding sex: preterm 19 case male, 34 cases female and in near and full term 10 cases male, 9 cases female. Maternal hypertension was in 23.5%, UTI was in 49.7% and PROM was in 23, 6%. IUGR and neonatal sepsis were significant in preterm than near&fullterm. Formula feeding was recorded most common in cases with NEC at 62% in preterm and 57.6% in near and full-term. Higher prevalence of leukocytosis in 74.5% in preterm and 68.4% near and fullterm, as well as Thrombocytopenia in 51% in preterm and 42.2% in near and fullterm metabolic acidosis was common in 62.7% in preterm, 57.8% in near and fullterm. Hyperglycemia was common in 51% in preterm, and in 10.52% in near and fullterm. +ve CRP was in 66.7% in preterm, and in 47.4% in near and fullterm. Blood culture is essential for anaerobic organisms. Abdominal ultrasound, Abdominal plain erect, Follow up x-ray once done to all studied cases except Follow up x-ray every 6 hours during 1st 2-3days not done at all. The adopted guidelines in management of NEC were used in all 100% of cases: Stop enteral feedings immediately. Support IV fluids and TPN to maintain basal nutritional needs (90-110 kcal/kg/day), gastric drainage by appropriate-sized nasogastric Start ampicillin IV (100 mg/kg/day every 8-12 hrs) and gentamicin IV (4-5mg/kg/dose every 24-48 hrs) or cefotaxime IV (100-150 mg/kg/day every 8-12 hrs). Add metronidazole (15-30 mg/kg/day every12 hrs) for anaerobic coverage.