Ver el código de «Necrotizing enterocolitis»

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==Background==

*Abbreviation: NEC
*Intestinal necrosis in previously well infant
*Typically presents in 1st week of life, with case reports to 6 months in children that are chronically ill.
*Predominantly affects preemies; 10-15% occurs in full-term patients
*Bacterial overgrowth in bowel, translocation of bacteria into bowel wall, subsequent bacterial endotoxin and gas production


==Clinical Features==

*[[Special:MyLanguage/Failure to thrive (peds)|Poor feeding]], [[Special:MyLanguage/altered mental status (peds)|lethargy]], [[Special:MyLanguage/abdominal pain|abdominal distention/tenderness]]
*[[Special:MyLanguage/Sepsis|Sepsis]], pneumoperitoneum


==Differential Diagnosis==

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{{Pediatric abdominal pain DDX}}
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==Evaluation==

[[File:Necrotizing enterocolitis 202.jpg|thumb|Neonate with necrotizing enterocolitis.]]
[[File:PMC3800332 IJA-57-387-g001.png|thumb|Left: [[Special:MyLanguage/KUB|KUB]] with pneumatosis intestinalis (large arrow) a specific finding in necrotizing enterocolitis. Right: follow-up film showing free air indicating bowel perforation (small arrow).]]

===Work-Up===

*CBC
*Chem
*[[Special:MyLanguage/Sepsis (peds)|Sepsis]] evaluation
*Coags
*Stool +/- heme positive


===Radiography===

*Pneumatosis on XR is hallmark
**Get [[Special:MyLanguage/KUB|KUB]] in supine position and left lat decubitus
*[[Ultrasound: Abdomen|Ultrasound]]
**Pseudo-kidney sign - bowel wall with hyperechoic center and hypoechoic rim
**Assess for gas bubbles in liver and portal veins


==Management==

#NPO
#Aggressive [[Special:MyLanguage/IVF|IV hydration]]
#[[Special:MyLanguage/Ampicillin|Ampicillin]] + [[Special:MyLanguage/gentamicin|gentamicin]] + [[Special:MyLanguage/clindamycin|clindamycin]]
#Surgery consult


==Disposition==

*Admit


==See Also==

*[[Special:MyLanguage/Abdominal pain (peds)|Abdominal pain (peds)]]


==References==

<references/>


[[Category:Pediatrics]]
[[Category:GI]]
[[Category:Surgery]]
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