Necrotizing enterocolitis: Difference between revisions
| Line 7: | Line 7: | ||
==Clinical Features== | ==Clinical Features== | ||
*Poor feeding, lethargy, abdominal distention/tenderness | *Poor feeding, lethargy, abdominal distention/tenderness | ||
*Sepsis, pneumoperitoneum | *[[Sepsis]], pneumoperitoneum | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 11:58, 19 December 2015
Background
- Abreviation: NEC
- Intestinal necrosis in previously well infant
- Predominantly affects preemies; 10-15% occurs in full-term pts
- Bacterial overgrowth in bowel, translocation of bacteria into bowel wall, subsequent bacterial endotoxin and gas production
Clinical Features
- Poor feeding, lethargy, abdominal distention/tenderness
- Sepsis, pneumoperitoneum
Differential Diagnosis
Pediatric Abdominal Pain
0–3 Months Old
- Emergent
- Nonemergent
3 mo–3 y old
- Emergent
- Nonemergent
3 y old–adolescence
- Emergent
- Nonemergent
Diagnosis
Work-Up
- CBC
- Chem
- Sepsis evaluation
- Coags
- Stool +/- heme positive
Radiography
- Pneumatosis on XR is hallmark
- Get KUB in supine position and left lat decubitus
- US
- Pseudo-kidney sign - bowel wall with hyperechoic center and hypoechoic rim
- Assess for gas bubbles in liver and portal veins
Treatment
- NPO
- Aggressive IV hydration
- Ampicillin + gentamycin + clindamycin
- Surgery consult
Disposition
- Admit
See Also
Source
Tintinalli