Necrotizing enterocolitis: Difference between revisions
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#NPO | #NPO | ||
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# | #[[Ampicillin]] + [[gentamycin]] + [[clindamycin]] | ||
#Surgery consult | #Surgery consult | ||
Revision as of 11:56, 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, abd distention/tenderness
- Sepsis, pneumoperitoneum
- Stool is +/- heme +
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
Labs
- CBC
- Chem
- Sepsis evaluation
- Coags
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
See Also
Source
Tintinalli