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Year Three - Paediatrics > Necrotising Enterocolitis > Flashcards

Necrotising Enterocolitis Flashcards

1
Q

What is necrotising enterocolitis (NEC)?

A

It is defined as a surgical emergency, in which acute bowel inflammation results in necrosis

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2
Q

What is the most common surgical emergency in the neonatal period?

A

Necrotising Enterocolitis

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3
Q

What is the pathophysiological cause of necrotising enterocolitis?

A

There is damage to the intestinal mucosa due to vascular insults, toxin exposure, infection or genetic factors

This damage allows pathogenic colonisation of normal commensal bacteria

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4
Q

What is the pathophysiological consequence of necrotising enterocolitis?

A

It can lead to bowel perforation, peritonitis and ultimately septic shock

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5
Q

What seven risk factors are associated with necrotising enterocolitis?

A

Premature < 32 Weeks

Low Birth Weight

Formula Feeding

Enteral Feeding

Respiratory Distress

Congenital Heart Disease

Antibiotic Administration

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6
Q

When does necrotising enterocolitis tend to present?

A

A corrected gestational age of 30 – 33 weeks

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7
Q

What are the seven clincial features of necrotising enterocolitis?

A

Feeding Intolerance

Green Bile Vomiting

Abdominal Distension

Abdominal Tenderness

Palpable Abdominal Mass

Reduced Bowel Sounds

Haematochezia

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8
Q

What is haematochezia?

A

It is defined as the presence of fresh blood in stools

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9
Q

What four investigations are used to diagnsoe necrotising enterocolitis?

A

Blood Tests

Arterial Blood Gas (ABG)

Abdominal Ultrasound Scans

Abdominal X-Rays

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10
Q

What four blood test results indicate necrotising enterocolitis?

A

Decreased Neutrophil Levels

Decreased Platelet Levels

Increased CRP Levels

Positive Blood Culture

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11
Q

What three ABG features indicate necrotising enterocolitis?

A

Decreased pH Levels

Increased Bicarbonate Levels

Increased Lactate Levels

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12
Q

When are abdominal ultrasound scans used to diagnose necrotising enterocolitis?

A

They are the first line investigation

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13
Q

What are the three features of necrotising enterocolitis on abdominal ultrasound scans?

A

Portal System Air Bubbles

Abdominal Ascites

Bowel Perforation

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14
Q

What is the gold standard investigation used to diagnose necrotising enterocolitis?

A

Abdominal X-Rays

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15
Q

What are the seven features of necrotising enterocolitis on abdominal x-rays?

A

Dilated Bowel Loops

Thickened Bowel Wall

Pneumatosis Intestinalis

Portal Venous Gas

Pneumoperitoneum

Rigler Sign

Football Sign

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16
Q

What is pneumatosis intestinalis?

A

It is defined as the presence of gas in the bowel wall

17
Q

What is pneumoperitoneum? What does it indicate in necrotising enterocolitis?

A

It is defined as the presence of free gas in the peritoneal cavity

Bowel Perforation

18
Q

What is Rigler sign?

A

It is when both sides of the bowel wall are visble

It occurs when there is presence of gas inside the bowel lumen and within the peritoneal cavity

19
Q

What is the football sign?

A

It is when air outlines the falciform ligament

20
Q

What is the most appropriate management option in suspected necrotising enterocolitis?

A

Urgent referral to paediatric surgery

21
Q

What are the five immediate management options of necrotising enterocolitis?

A

Nil By Mouth

Total Parenteral Nutrition

Nasogastric Tube Insertion

IV Fluids

IV Antibiotics

22
Q

Name two antibiotics used to manage necrotising enterocolitis

A

Cefotaxime

Metronidazole

23
Q

What is the surgical management option of necrotising enterocolitis?

A

Bowel Laparoscopy

24
Q

When is bowel laparoscopy used to manage necrotising enterocolitis?

A

It is used to manage necrotising enterocolitis, in which bowel perforation development has occurred

25
Q

What is bowel laparoscopy?

A

It involves removal of the perforated and necrotic bowel from the abdomen

26
Q

What are the six complications used to manage necrotising enterocolitis?

A

Bowel Perforation

Peritonitis

Septic Shock

Short Bowel Syndrome

Bowel Strictures

Bowel Abscess

Year Three - Paediatrics (29 decks)

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