Adult ischemic necrotizing enterocolitis.

A 66-year-old male presented with posterior myocardial infarction and painless rectal bleeding. He was treated for acute coronary event but despite extensive investigations the cause of his lower gastrointestinal bleeding remained elusive. Patient died 5 days after admission. Postmortem examination showed evidence of severe atherosclerosis and thrombosis in branches of abdominal aorta leading to bowel ischemia with multiple perforations and necrosis. The findings are consistent with the diagnosis of necrotizing enterocolitis (NEC). Main factors responsible for pathogenesis of NEC are bowel ischemia and bacterial infection. It can be classified into 3 stages according to the level of severity. Treatment ranges from mainly supportive in the initial phase to surgery in severe cases.