What are the characteristics of Bell stage III necrotizing enterocolitis (NEC)?

Updated: Dec 27, 2017
  • Author: Shelley C Springer, JD, MD, MSc, MBA, FAAP; Chief Editor: Muhammad Aslam, MD  more...
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This stage represents advanced, severe NEC that has a high likelihood of progressing to surgical intervention.

Stage IIIA characteristics are as follows:

  • Patient has severe NEC with an intact bowel

  • Diagnosis requires all of the above conditions, with the addition of hypotension, bradycardia, respiratory failure, severe metabolic acidosis, coagulopathy, and/or neutropenia

  • Abdominal examination shows marked distention with signs of generalized peritonitis

  • Radiographic examination reveals definitive evidence of ascites

Stage IIIB designation is reserved for the severely ill infant with perforated bowel observed on radiograph in addition to the findings for IIIA.

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