Necrotising enterocolitis

Question 1

when is necrotising enterocolitis most common

Answer 1

second week of life

Question 2

what part of the bowel is most commonly affected

Answer 2

distal terminal ileum and proximal colon

Question 3

what group of patients are typically affected

Answer 3

preterm babies

Question 4

what are the early signs of necrotising enterocolitis

Answer 4

non-specific illness
vomiting/bilious aspirate from gastric tube
poor feed tolerance
abdominal distention

Question 5

what investigations should you do

Answer 5

abdominal XR

FBC, U&E, coag, albumin, blood gas, cultures, group and save

Question 6

what would you see on abdominal XR

Answer 6

dilated loops of large bowel

Question 7

give some risk factors for necrotising enterocolitis

Answer 7

prematurity
hypoxia
polycythemia
IUGR
exchange transfusion
hyperosmolar milk feeds

Question 8

how do you manage necrotising enterocolitis

Answer 8

stop milk feeds for 10-14 days
insert gastric tube
IV antibiotics for 10-14 days

systemic support

consider surgery

Question 9

what is the overall mortality from necrotising enterocolotiis

Answer 9

22%

Question 10

what are some late signs of necrotising enterocolitis

Answer 10

abdominal tenderness
blood/mucous in stools
shock
bowel perforation