Necrotising enterocolitis Flashcards
What is necrotising enterocolitis?
An infected and necrotic bowel affecting preterm neonates
What are the risk factors for developing NEC?
Very low birthweight
Very premature
Non-breast milk feeds (including expressed breast milk feeds)
Respiratory distress or ventilation
Sepsis
Congenital heart disease
How does NEC present?
Intolerance to feeds
Bilious vomiting
Distended abdomen
Absent bowel sounds
Blood in stools
What is the definitive investigation for diagnosis of NEC?
Abdominal X-ray
What might be seen on an abdominal X-ray in a child with NEC?
Dilated bowel
Thickened bowel wall
Pneumatosis intestinalis - air in the bowel wall
Pneumoperitoneum - air in the peritoneal cavity
What other investigations can be carried out to help diagnose NEC?
FBC - thrombocytopenia, neutropenia
CRP - inflammation
Capillary blood gas - metabolic acidosis
Blood culture - sepsis
What is the treatment of NEC?
IV fluids
Nil by mouth
Antibiotics
Bowel decompression by NG tube
Immediate surgical referral
What are the complications of NEC?
Sepsis
Bowel stricture
Perforation and peritonitis
Recurrence
Long term stoma
