Necrotising enterocolitis (NEC)

Question 1

What investigations are useful in diagnosing necrotising enterocolitis?

Answer 1

abdominal X ray - will show dilated bowel loops, bowel wall oedema, intramural gas, portal venous gas, pneumoperitoneum.

Question 2

What is the football sign in NEC?

Answer 2

air outlining the falciform ligament on AXR

Question 3

What is Rigler sign in NEC?

Answer 3

air both inside and outside the bowel wall

Question 4

What is the name for intramural gas in NEC?

Answer 4

pneumatosis intestinalis

Question 5

What are the early signs/symptoms that alert to a diagnosis of NEC?

Answer 5

feeding intolerance with abdominal distension and fresh bloody stools; there can also be bilious vomiting

Question 6

What are the late signs/symptoms that alert to a diagnosis of NEC?

Answer 6

abdominal discolouration, perforation and peritonitis

Question 7

What population is NEC most commonly found?

Answer 7

premature infants (also more common in bottle fed infants)

Question 8

What is the immediate management for NEC?

Answer 8

Broad spectrum antibiotics

Question 9

What antibiotic can be given to prevent enterocolitis antenatally?

Answer 9

Erythromycin