قراءة
عرض

NECROTIZING ENTEROCOLITIS:

- An acute intestinal necrosis
resulting from ischemia and /or
reperfusion injury.
- It is less common in breast fed
infants.
- Commonly seen in VLBW infants.
- Mortality reaches 22 %.

factors: Risk

Prematurity.
Perinatal Asphyxia.
Polycythemia.
Umbilical catheterization.
Hypothermia.
Empirical antibiotic use(> 5 days).
.

CLINICAL PRESENTATION:

• - Bloody diarrhea ( 25 %).
-Tense ,distended ,tender abdomen with
edema and inflammation of abdominal wall
(Peau d orange appearance).
• - Ascites is a late sign.
• -The baby might pass into septic shock.

Advanced cases will have a

triad of :

1 . Thrombocytopenia .

2 . Persistent metabolic acidosis .
3 . Refractory hyponatremia .

Diagnosis:


1 .X - ray abdomen&Abdominal ultrasound :
.Intramural gas (pneumatosis intestinalis).

.Gas in the portal tree.

.Gas under the diaphragm which follows
intestinal perforation.

• 2 . C.B.C. :Thrombocytopenia with low

or increased WBC count.
3 . Blood culture.

• 4 . Hyperkalemia.

MANAGEMENT:
• 1 . Stop oral feeding.

• 2 . NG tube drainage.

• 3 . Correct electrolytes , acidosis and
hypothermia.

• 4 . Antibiotics:

Ampicillin+Gentamicin+Metronidazole
• .

• 5 . Remove umbilical catheters.

• 6 . Assisted ventilation.

• 7 . Treat hypotension by i.v. fluid, plasma,

blood,dopamine.

• 8 . T.P.N.

COMPLICATIONS:

- Perforation .

- Acquired short bowel syndrome (following
surgery).
- DIC .
- - Sepsis and shock .
- Abscess formation.


رفعت المحاضرة من قبل: Ahmed monther Aljial
المشاهدات: لقد قام عضو واحد فقط و 53 زائراً بقراءة هذه المحاضرة






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