Necrotizing enterocolitis: Pathophysiology from a historical context

Semin Pediatr Surg. 2018 Feb;27(1):11-18. doi: 10.1053/j.sempedsurg.2017.11.003. Epub 2017 Nov 6.


Necrotizing enterocolitis (NEC) continues to afflict approximately 7% of preterm infants born weighing less than 1500g, though recent investigations have provided novel insights into the pathogenesis of this complex disease. The disease has been a major cause of morbidity and mortality in neonatal intensive care units worldwide for many years, and our current understanding reflects exceptional observations made decades ago. In this review, we will describe NEC from a historical context and summarize seminal findings that underscore the importance of enteral feeding, the gut microbiota, and intestinal inflammation in this complex pathophysiology.

Keywords: Breast milk; Endotoxin; Necrotizing enterocolitis; Neonatal sepsis; Surgery; Toll like receptor.

Publication types

  • Historical Article
  • Review

MeSH terms

  • Enterocolitis, Necrotizing / history*
  • Enterocolitis, Necrotizing / microbiology
  • Enterocolitis, Necrotizing / physiopathology*
  • Europe
  • Gastrointestinal Microbiome
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / history*
  • Infant, Premature, Diseases / microbiology
  • Infant, Premature, Diseases / physiopathology*
  • United States