Pathogenesis :

• Role of immature Gastrointestinal host defenses
• Role of infectious agents & bacterial toxins
• Role of inflammatory mediators
• Role of oxygen radicals & ischemia reperfusion injury
  
  

Pathology :

Common sites are terminal ileum and ascending colon.

Clinical features :

• Symptoms may appear within 96 hrs after initiation of feeds
• Majority of cases occur within first 10 days of life
• Onset may be insidious / explosive / delayed
• Earliest signs : abdominal distension, retention of milk in a sick-looking LBW infant.
• Clinical triad : Abdominal. Distension + GI bleeding + Pneumatosis intestinalis
• Signs of functional Intestinal obstruction : Abdominal distension, progressive decreased Peristalsis, Bilious vomiting, hematemesis and blood in stools
• Signs of peritonitis & perforation: Ascites, erythema & edema of abdominal wall, localized mass or rigidity
• Systemic signs : respiratory distress, Apnea / bradycardia, Lethargy, thermal instability, irritability, poor feeding, hypotension (shock), oliguria, bleeding diathesis, sclerema