Coagulation studies are normal. A urine toxicology screen on the infant is negative. An Apt test done on the hematemesis residue on the blanket is negative for fetal hemoglobin indicating that the blood on the blanket did not come from the infant. The abdominal series is cancelled. NEC presents in the neonatal period with signs and symptoms that include guaiac positive stool, poor feeding, vomiting, hematemesis, abdominal distention, abdominal discoloration, abdominal tenderness, bowel obstruction, or other findings suggestive of an acute abdomen.
Premature infants are at highest risk.
It is unlikely to occur in healthy term infants. This is generally not a condition that presents as an outpatient to an emergency department. It is most often diagnosed by neonatologists in intensive care level low birth weight infants. Infants with NEC should be managed in a neonatal special care unit. Despite this, pediatricians and neonatologists may occasionally refer outpatient newborns to an emergency department to investigate the possibility of NEC in a newborn who was previously discharged.