Necrotizing enterocolitis: Difference between revisions

Revision as of 11:49, 19 December 2015

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

Labs

Imaging

Cross-table lateral to detect free air
- Pneumatosis intestinalis, pneumobilia, pneumoperitoneum, sentinel loops, portal gas

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

Tintinalli

Authors:

@@ Line 5: / Line 5: @@
 *Bacterial overgrowth in bowel, translocation of bacteria into bowel wall, subsequent bacterial endotoxin and gas production
-==Diagnosis==
+==Clinical Features==
 *Poor feeding, lethargy, abd distention/tenderness
 *Sepsis, pneumoperitoneum
 *Stool is +/- heme +
+==Differential Diagnosis==
+*[[Sepsis (peds)|Sepsis]]
+*[[Pneumonia (peds)|Pneumonia]]
+*malro/volvulus
+*feeding intolerance (exclusion)
+{{Pediatric abdominal pain DDX}}
 ==Work-Up==
@@ Line 26: / Line 34: @@
 **Pseudo-kidney sign - bowel wall with hyperechoic center and hypoechoic rim
 **Assess for gas bubbles in liver and portal veins
-==Differential Diagnosis==
-*[[Sepsis (peds)|Sepsis]]
-*[[Pneumonia (peds)|Pneumonia]]
-*malro/volvulus
-*feeding intolerance (exclusion)
-{{Pediatric abdominal pain DDX}}
 ==Treatment==