Necrotizing Enterocolitis: One Case, Every Call the Team Made
Carousel1 min read·Published Oct 2026

Necrotizing Enterocolitis: One Case, Every Call the Team Made

Clinical presentation of necrotizing enterocolitis in a premature infant at 28 weeks gestation.
Clinical decision slide on necrotizing enterocolitis workup with equivocal X-ray findings and ultrasound recommendation.
Clinical decision slide discussing management of deteriorating 900g infant with free air and acidosis.
Slide describing intraoperative decision-making between primary anastomosis and stoma creation in an unstable infant.
Blue slide summarizing NEC management principles: judgment calls under pressure, evolving research, trust data and team.
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Carousel · Oct 2026 · 1 min read

In brief

In brief

Case-based educational carousel reviewing the clinical decision-making process in managing necrotizing enterocolitis. Presents the sequential management decisions made by the multidisciplinary team from initial presentation through treatment, illustrating real-world surgical reasoning in this critical neonatal condition.

Written by the GCMD Library team from the carousel.

Slides

5 pages · click to turn to one

A structured comparison chart displaying three treatment modalities side-by-side with colored sections. Each column contains clinical data, success percentages, and outcome metrics. Visual hierarchy uses headers, bullet points, and percentage callouts to organize information about surgical techniques.

Necrotizing enterocolitis. A social-media carousel made possible by Cincinnati Children's.
The text in the image

Pediatric Achalasia: Surgical Approach Comparison | Heller Myotomy | 78% Success Rate | Esophageal Dilatation | 45% Success Rate | POEM (Peroral Endoscopic Myotomy) | 99% Success Rate | 742 Cases Reviewed | Complications | Training Requirements | Long-term Outcomes | Ambulation Rates | Neuroprotection | Clinical Efficacy

The text on each slide
  1. Made possible by Cincinnati Children's | 28 weeks. | 900 grams. | Day 12 of life. | This is necrotizing enterocolitis: one case, and every call the team had to make. | Stable on CPAP and trophic feeds — until distension, vomiting, and bloody stool.
  2. DAY 12 · THE WORKUP | Made possible by Cincinnati Children's | The X-ray won't commit. | Exam: distension, bloody stool, tachycardia. | Labs: acidosis, high CRP. | But the X-ray is equivocal... no free air, just bubbles. | THE MOVE | Triple antibiotics + bowel rest — and reach for ultrasound. X-ray catches only 13-25% of early surgical NEC.
  3. DAY 14 · THE CRASH | Made possible by Cincinnati Children's | Now there's free air. | The baby worsens - develops acidosis and progressive abdominal distension. | Inotropes are started, vent settings are increased, and blood is transfused. | Drain at the bedside or the OR? | Take this 900g human to laparotomy? The majority go to the OR.
  4. IN THE OR · THE PIVOT | Made possible by Cincinnati Children's | The plan changed on the table. | Stoma — or sew the ends back together? | STAT trial: in stable babies, primary anastomosis recovers faster. So that was the plan. | Then the baby became markedly unstable mid-op. | The call flipped, a stoma instead.
  5. BOTTOM LINE | Made possible by Cincinnati Children's | NEC is a chain of judgment calls under pressure — and the plan can change on the table. | Even after: research on mucus fistula refeeding and earlier stoma closure keep evolving. | Trust your imaging, your data, and your team. | Information from the NEC management podcast with Drs. Augusto Zani, Simon Eaton & Dan Ostlie.
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