Delayed Recurrence of Feed Intolerance after Necrotizing Enterocolitis

Abstract

Feed intolerance is a common problem in preterm and growth-restricted neonates, which can be caused by numerous etiologies. The exact etiology can be ascertained based on clinical presentation, timing of onset, course of illness, laboratory parameters and/or radiological investigations. We report a 29-week preterm neonate treated for necrotising enterocolitis (NEC) stage 2A and culture-positive sepsis, who presented with feed intolerance in the 7th week of life. Feed intolerance was mainly in the form of gradual-onset abdominal distention after the attainment of full enteral feeds. There were no other features of feed intolerance or any systemic signs. Upon lower gastrointestinal contrast study, the neonate was diagnosed with post-NEC stricture of the descending colon. This report highlights an unusual cause of feed intolerance in a preterm neonate, which needs a high index of suspicion for diagnosis, in presence of the background of medically-treated NEC.