Table 2.
Modified bell’s criteria for NEC
| Stage | Systemic signs | Intestinal signs | Radiological signs |
|---|---|---|---|
| I. Suspected | |||
| A | Temperature instability, apnea, bradycardia | Elevated pregavage residuals, mild abdominal distension, occult blood in stool | Normal or mild ileus |
| B | Same as IA | Same as IA, plus gross blood in stool | Same as IA |
| II. Definite | |||
| A: Mildly ill | Same as IA | Same as I, plus absent bowel sounds abdominal tenderness | Ileus, pneumatosis intestinalis |
| B: Moderately ill | Same as I, plus mild metabolic acidosis, mild thrombocytopenia | Same as I, plus absent bowel sounds, definite abdominal tenderness, abdominal cellulitis, right lower quadrant mass | Same as IIA, plus portal venous gas, with or without ascites |
| III. Advanced | |||
| A: Severely ill, bowel intact | Same as IIB, plus hypotension, bradycardia, respiratory acidosis, respiratory acidosis, disseminated intravascular coagulation, neutropenia | Same as I and II, plus signs of generalized peritonitis, marked tenderness and distension of abdomen | Same as IIB, plus definite ascites |
| B: Severely ill: bowel perforated | Same as IIIA | Same as IIIA | Same as IIB plus pneumoperitoneum |