Necrotising enterocolitis

Question 1

What is necrotising enterocolitis?

Answer 1

Most common SURGICAL emergency in babies
Immature/fragile bowels -cause unkown-combination of poor blood flow and infection AFTER enteral feeding

RF - premature and LBW, PDA

Sx-
Early signs - Biliary vomiting, feeding intolerance
Abdomen distention, blood stained stools, rapid deterioation and stools
(apnea, brady, lethargy, temp)
Gastric retenstion

late stage -absent bowel sounds
can have signs of acidosis, DIC, neutropenia
Peritonitis
Ascites

Question 2

Ix and Mx of Necrotising enterocolitis

Answer 2

Ix -
AXR -gas cyst in bowel walls -see air under diaphrahm (perfo), rigglers sign, distended bowels,
Blood cultures

Mx-
Bells staging for management (signs that indicate probable to very likely

early/not severe -bowel rest (sop oral and switch to parental feed)
Broad spectrum ABx -cefrotaxime
Laprotomy (if see perforation on AXR)

20% mortality/morbitidity- and long term had strictures, malabsorbtion of resection was neede