1
Q
what
A
disorder effecting premature neonates where part of bowel becomes necrotic
can lead to perforation
2
Q
risk factors
A
very low birth weight very premature resp distress and assisted ventilation sepsis PDA + other congenital heart disease
3
Q
features
A
intolerant to feeds vomit esp bilious unwell distended, tender abdo absent bowel sounds blood in stool
4
Q
features if perforation occurs
A
peritonitis
shock
severely unwell
5
Q
investigation of choice
A
abdo xray
6
Q
blood tests
A
thrombocytopenia, neutropenia
CRP
cap blood gas - metabolic acidosis
blood cultures
7
Q
abdo xray findings
A
dilated loops of bowel
bowel wall oedema
pneumatosis intestinalis
pneumoperitoneum
8
Q
Pneumatosis intestinalis
A
gas in bowel wall
sign of NEC
9
Q
Mx
A
NMB
IV fluids
TPN
antib
immediate referral to neonate surgical team
10
Q
complications
A
perforation + peritonitis sepsis death strictures abscess recurrent long term stoma short bowel syndrome
