Necrotising Enterocolitis/NEC (1)

Question 1

What is this?
→ What can it lead to?

When does it usually present?

How does it present?

What is heard O/E?

Answer 1

➊ Disorder affecting premature neonates where part of the bowel becomes ischaemic and infected
→ Perforation, which can cause peritonitis and shock

➋ In first 3 wks of life

➌ • Abdominal distension
• Bilious vomiting
• Bloody stools

➍ Absent bowel sounds

Question 2

Which investigations should be done?

Which signs will be seen on AXR?

Answer 2

➊ • Bloods – FBC, WCC, CRP, Culture
• Blood gas – Metabolic (lactic) acidosis
• AXR

➋ • Pneumatosis Intestinalis – Gas within bowel wall
• Dilated bowel loops
• Bowel wall oedema
• Gas in portal veins
• Pneumoperitoneum if perforation occurs

Question 3

What are its complications?

How is it managed?

Answer 3

➊ • Perforation
• Peritonitis and Sepsis
• Strictures
• Abscess
• Short bowel syndrome after surgery

➋ • NBM, NGT, IVF, Abx
• Total parenteral nutrition to rest the bowel
• Bowel resection of necrotic sections