One of the leading causes of death amongst premature infants

Clinical features

Initial symptoms:

• feeding intolerence
• abdominal distension
• bloody stools

Can quickly progress to:

• abdominal discolouration
• perforation
• peritonitis

Investigations

Abdominal x-rays:

• dilated bowel loops (often asymmetrical in distribution)
• bowel wall oedema
• pneumatosis intestinalis (intramural gas)
• portal venous gas
• pneumoperitoneum resulting from perforation
• air both inside and outside of the bowel wall (Rigler sign)