Necrotising enterocolitis Flashcards
1
Q
What does necrotising enterocolitis cause?
A
Necrotic -> perforation -> peritonitis _> shock -> life threatening emergency
2
Q
Risk factors for NEC
A
- Very low birth weight or very premature
- Formula feeds (it is less common in babies fed by breast milk feeds)
- Respiratory distress and assisted ventilation
- Sepsis
- Patient ductus arteriosus and other congenital heart disease
3
Q
Presentation of NEC
A
- Intolerance to feeds
- Vomiting, particularly with green bile
- Generally unwell
- Distended, tender abdomen
- Absent bowel sounds
- Blood in stools
4
Q
Blood tests for NEC
A
- Full blood count for thrombocytopenia and neutropenia
- CRP for inflammation
- Capillary blood gas will show a metabolic acidosis
- Blood culture for sepsis
5
Q
Investifation of choice for NEC
A
Abdo X ray supine
6
Q
What is lateral decubitis position X ray
A
From side with neonate on side
7
Q
What X ray show in NEC
A
- Dilated loops of bowel
- Bowel wall oedema (thickened bowel walls)
- Pneumatosis intestinalis is gas in the bowel wall and is a sign of NEC
- Pneumoperitoneum is free gas in the peritoneal cavity and indicates perforation
- Gas in the portal veins
8
Q
What does penumoperitoneum indicate?
A
Perforation
9
Q
Management of NEC
A
IV fluids, TPN, antibipotics
NG tibe
Surgical emergency
Temporary stoma
Nil by mouth
10
Q
Complications of NEC
A
- Perforation and peritonitis
- Sepsis
- Death
- Strictures
- Abscess formation
- Recurrence
- Long term stoma
- Short bowel syndrome after surgery
10
Q
Complications of NEC
A
- Perforation and peritonitis
- Sepsis
- Death
- Strictures
- Abscess formation
- Recurrence
- Long term stoma
- Short bowel syndrome after surgery
