Necrotising Enterocolitis Flashcards
1
Q
What is necrotising enterocolitis (NEC)?
A
A disorder affecting premature neonates where part of the bowel becomes necrotic.
2
Q
Why is NEC considered a life-threatening emergency?
A
Death of bowel tissue can lead to perforation, peritonitis, and shock.
3
Q
What are some risk factors for NEC?
A
- Very low birth weight or very premature
- Formula feeds (less common in breastfed babies)
- Respiratory distress and assisted ventilation
- Sepsis
- Patent ductus arteriosus and other congenital heart disease
4
Q
What are common clinical features of NEC?
A
- Intolerance to feeds
- Vomiting, particularly green bile
- Generally unwell
- Distended, tender abdomen
- Absent bowel sounds
- Blood in stools
5
Q
What blood tests are used in the investigation of NEC?
A
- FBC (thrombocytopenia, neutropenia)
- CRP (raised with inflammation)
- Capillary blood glucose (metabolic acidosis)
- Blood culture (sepsis)
6
Q
What imaging findings are associated with NEC on an abdominal x-ray?
A
- Dilated bowel loops (often asymmetrical)
- Thickened bowel walls (oedema)
- Pneumatosis intestinalis (gas in bowel wall - intramural)
- Pneumoperitoneum (free gas in peritoneal cavity, indicates perforation)
- Rigler sign (air inside and outside bowel wall)
- Football sign (air outlining falciform ligament)
7
Q
What is the management protocol for NEC?
A
- Nil by mouth (total parenteral nutrition)
- IV fluids
- Antibiotics
- NG tube (drain fluids and gas)
- Surgery!
8
Q
What are potential complications of NEC?
A
- Sepsis
- Perforation and peritonitis
- Death
- Strictures
- Abscess formation
- Recurrence
- Long term stoma
- Short bowel syndrome after surgery
9
Q
Fill in the blank: The presence of gas in the bowel wall is known as _______.
A
pneumatosis intestinalis
10
Q
True or False: Breastfed babies are at a higher risk for developing NEC compared to formula-fed babies.
A
False
