Neonatology Flashcards
What is necrotising enterocolitis and what are risk factors for it?
Where parts of the bowel become necrotic
Prematurity
Very low birth weight
Formula fed
Hypoxia/respiratory distress
Polycythaemia
How does necrotising enterocolitis present and what are the differentials?
Presentation:
- Feeding intolerance
- Abdominal distension
- Bilious vomiting
- Bloody stools
- Absent bowel sounds
- Systemically unwell
- Peritonitis signs if severe
Differentials:
- Sepsis
- Hirschsprung’s
- GORD
- Intestinal malrotation
- Spontaneous perforation
Necrotising enterocolitis investigations
FBC (low neutrophils + platelets)
Blood gas (metabolic acidosis)
Blood culture (sepsis)
U&Es (low sodium)
Diagnosis by supine abdo X-Ray (Bell staging system)
Positie findings = dilated bowel loops, intramural gas, bowel wall thickening, pneumoperitoneum)
Management and complications of necrotising enterocolitis
Prophylaxis - antenatal steroids, breast feeding
Medical - TPN, IV fluids + abx, correction of FBC, U&Es
Surgical (if perforation/no improvement) - removal of dead bowel + temporary stoma
Complications:
- strictures
- abscesses
- peritonitis
- sepsis
- death