Necrotising entero-colitis Flashcards
What is neonatal necrotizing enter-colitis?
Condition where part of the bowel becomes necrotic
What can bowel necrosis lead to?
Bowel perforation.
What can bowel perforation result?
Peritonitis and shock.
What is the initial presentation of necrotising entero-colitis?
- Feeding intolerance
- Abdominal distension
- Bloody stools
What can necrotising enter-colitis quickly progress to?
- Abdominal discolouration
- Perforation (hole)
- Peritonitis (inflammation of the peritoneum)
What is the main investigation for necrotising entero-colitis?
Abdominal X-ray
What can be seen on an x-ray of necrotising enter-colitis?
- dilated bowel loops
- air in the biliary tree
- bowel wall oedema
- pneumatosis intestinalis (intramural gas)
- portal venous gas
- pneumoperitoneum resulting from perforation
- air both inside and outside of the bowel wall (Rigler sign)- confirm diagnosis
- air outlining the falciform ligament (football sign)- confirm diagnosis
What 2 signs can be used to confirm the diagnosis of necrotising entero-colitis?
Rigler sign
Football sign
What is Rigler sign?
Air both inside and outside of the bowel wall
What is Football sign?
Air outlining the falciform ligament
What would you look for in the blood of someone with necrotising entero-colitis?
- Full blood count for thrombocytopenia and neutropenia
- CRP for inflammation
- Capillary blood gas will show a metabolic acidosis
- Blood culture for sepsis
What would you look for in a full blood count in someone with necrotising entero-colitis?
Thrombocytopenia and neutropenia
What will the blood gas of someone with necrotising entero-colitis show?
Metabolic acidosis
What is the management of necrotising entero-colitis?
Nil by mouth with IV fluids
Total parenteral nutrition (TPN)
Broad spectrum antibiotics
What can be used to drain fluid and gas from the stomach and intestines?
Nasogastric tube
What might need to be done in an extreme case of necrotising entero-colitis?
Surgery may be required to remove the dead bowel tissue.
What might a child need if significant bowel is removed?
A temporary stoma
What are the possible complications of necrotising enter-colitis?
- Perforation and peritonitis
- Sepsis
- Death
What is a typical presentation of necrotising enterocolitis?
Bilous vomit
distended abdomen
not feeding
bloood in stool
abdominal x-ray: thickened bowel walls and air in bowel
History: premature rupture of membranes
In who does necrotising entero-colitis usually affect?
Premature babies
When does necrotising enterocolitis usually occur?
In the second or third week of life
What are the main x-ray changes to look for?
dilated loops of bowel
bowel wall oedema
pneumatosis intestinalis (intramural gas)*
pneumoperitoneum (free gas in peritoneal cavity) resulting from perforation*
portal venous gas*
