Necrotising enterocolitis

Question 1

What is necrotising enterocolitis?

Answer 1

1. Bacterial invasion of the bowel wall
2. Inflammation of the bowel wall causing damage
3. May result in inscahemia and necrosis

Question 2

At what age is this condition most common?

Answer 2

Affects pre term infants in the first few weeks of life

Question 3

What may predispose the development of necrotising enterocolitis?

Answer 3

Pre term infants fed cow’s milk formula are more likely to develop it than if they are fed only breast milk.

Question 4

How does an infant with necrotizing enterocolitis present?

Answer 4

1. Feeds are not tolerated - milk aspirated/ bile stained vomiting
2. Abdomen becomes distended
3. Stool may have fresh blood

Question 5

Xray result for necrotising enterocolitis

Answer 5

1. Distended loops of bowel and thickening of bowel wall with intramural gas
   - may progress to bowel perforation

Question 6

Prognosis of necrotising enterocolitis

Answer 6

• infant may rapidly become shocked and require artificial ventilation due to abdominal distention and pain
• disease may progress to bowel perforation

Question 7

Tx of necrotising enterocolitis

Answer 7

• stop overfeeding and give broadspectrum antibiotics
• artificial ventiliataion, circulatory support etc may be needed
• Surgery has been performed for bowel perforation