Table 3 Clinical indications for surgical intervention in patients treated for NEC

1. Persistent abdominal distention and dilated loops of bowel on AXR despite course of medical therapy

2. Worsening abdominal distension, inability to tolerate enteral feeds, and significant thrombocytopenia

3. New pneumoperitoneum on serial imaging

4. Worsening thrombocytopenia and increasing ventilatory requirements

5. Failure to progress clinically with rising bilirubin, and obstructive pattern seen on imaging with concern for stricture

6. Clinical deterioration, fluid collection seen on AUS

7. Persistent pneumoperitoneum despite drain placement and worsening abdominal fluid collections

8. Worsening abdominal distension and discoloration, previously placed drain expressing succus

9. Clinical deterioration with succus from previously placed drain

10. Clinical deterioration with worsening thrombocytopenia