NEC UWorld Flashcards
What are the immediate management steps for necrotizing enterocolitis (NEC)?
- Discontinuation of enteral feeds
- Nasogastric decompression
- Blood cultures & empiric antibiotics
- Intravenous fluid repletion
What should be monitored in a patient with NEC?
- Serial complete blood count (CBC) & electrolytes
- Serial abdominal examinations & imaging
What are the indications for surgery in necrotizing enterocolitis (NEC)?
- Bowel perforation (pneumoperitoneum)
- Clinical deterioration despite medical management (suggestive of bowel necrosis)
What does pneumatosis intestinalis refer to in NEC?
Pneumatosis intestinalis refers to air in the bowel wall and is the hallmark x-ray finding in NEC. It occurs due to gas-producing bacteria invading the gut mucosal wall.
What are the common symptoms of necrotizing enterocolitis (NEC)?
- Feeding intolerance (eg, gastric residuals, bilious emesis)
- Tender and distended abdomen
- Gastrointestinal (GI) bleeding (eg, hematochezia, hematemesis)
What can happen if necrotizing enterocolitis (NEC) is not treated promptly?
Untreated NEC can lead to:
- Septic shock
- Bowel perforation
- Death
Why are blood cultures important in the management of NEC?
Blood cultures help identify the bacteremia that is common in NEC, and they should ideally be obtained before administering antibiotics to guide therapy.
When is surgery required in the management of NEC?
Surgery is needed when there is:
- Bowel perforation (free intraperitoneal air)
- Clinical deterioration (eg, vital sign instability, persistent acidosis despite medical management)
How does breastfeeding impact the risk of developing NEC?
Premature infants fed breast milk have a decreased risk of developing NEC compared to those who are formula-fed.
Are antenatal corticosteroids used in the treatment of NEC?
Antenatal corticosteroids are not part of NEC management. They are given to mothers at risk for preterm delivery to aid fetal lung maturity.
