necrotising enterocolitis and viral gastroenteritis

Question 1

what is NE

Answer 1

Necrotising enterocolitis (NEC) is a condition in which the bowel of premature infants becomes ischaemic and infected.

Question 2

RF for NE

Answer 2

Prematurity
Low birth weight
Non-breast-milk feeds
Sepsis
Acute hypoxia
Poor intestinal perfusion

Question 3

SX OF NE
usually premature(neonates) within the first 3 weeks of life

Answer 3

Vomiting (which may be bile streaked)

Bloody stools

Abdominal distension

Absent bowel sounds

systemic compromise including an acidosis on a blood gas

Question 4

sx of viral GE

Answer 4

diarrhoea - non bloody
vomiting
no signs of imaging

Question 5

NEC diagnosed by abdoXR what would it show

4 things

bells classification

Answer 5

Dilated bowel loops
Pneumatosis intestinalis (gas within the bowel wall)
Portal venous gas
Pneumoperitoneum

Question 6

1 in 3 patients with NEC perforate their bowel

Answer 6

nil-by-mouth- NGtube

Broad-spec abx

Total parenteral nutrition to rest the bowel

Supportive treatment with IV fluids and ventilation are also crucial

Surgery to resect necrotic sections of bowel may be necessary, and is essential in cases of bowel perforation. Paediatric surgeons should be contacted early and patients may need to transfer to a neonatal surgical unit.

Question 7

prevention of NEC

Answer 7

delayed cord clamping at delivery reduces the risk

breastfeeding