Neonatology Flashcards

1
Q

What is necrotising enterocolitis and what are risk factors for it?

A

Where parts of the bowel become necrotic

Prematurity
Very low birth weight
Formula fed
Hypoxia/respiratory distress
Polycythaemia

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2
Q

How does necrotising enterocolitis present and what are the differentials?

A

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

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3
Q

Necrotising enterocolitis investigations

A

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)

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4
Q

Management and complications of necrotising enterocolitis

A

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

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