Necrotizing enterocolitis
Necrotizing enterocolitis is an intestinal disorder found in the premature infants. The cause of this condition is multifactorial and includes chorioamnionitis, low birth weight, prematurity, formula feeding, neonatal polycythemia, intestinal dysbiosis, etc. This disease is characterized by the triad of: 1. Feeding intolerance 2. Abdominal distension 3. Bloody stools Other Gastrointestinal symptoms includes delayed gastric emptying, tender abdomen, decreased bowel sounds and abdominal wall erythema. Systemic symptoms includes apnea, lethargy, shock and cardiovascular collapse. Diagnosis includes: 1. On clinical symptoms 2. CBC: leukocytosis or neutropenia 3. X-ray Abdomen: Dilated or thicker bowel loops, pneumatosis intestinalis (airline the intestine), perforation with free abdominal gas and portal venous gas 4. Hepatic ultrasonography: Gas in portal vein. 5. Blood culture 6. Stool screening for blood 7. ABGs, Serum electrolytes, coagulation profile Management: 1. Supportive treatment to prevent further injury 2. NPO 3. Drainage of stomach contents by NG tube 4. Monitoring of vitals 5. Systemic antibiotics 6. Necrotic bowel is surgically resected. Picture credit: https://molmed.biomedcentral.com/articles/10.1186/s10020-018-0002-0