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Monday, January 31, 2011

NECROTIZING ENTEROCOLITIS

This is poorly understood disorder of the new born in which the baby develops lethargy, vomiting, bloody diarrhea, distention of abdomen, hypothermia and apnea. Terminally, he may go into cardiovascular collapse.



The condition is encountered usually in low birth weight babies born before term. It may however, occasionally, develop even in normal full term babies. Predisposing factors include maternal fever, amnionitis, sepsis, respiratory distress syndrome(usually of mild type) exchange transfusion and oral feeding with high osmolar (hypertonic) stuff.

Investigation show air-fluid levels, dilated loops of gut, separation of loops of gut and linear streaks of intraluminar air, pneumatosis intestinalis, which confirm the diagnosis.

Treatment is with antibiotics, intravenous fluids and supportive measures to maintain temperature.

Prognosis is bad. High mortality may result from such complications as perforation, abdominal wall cellulitis, and pneumoperitonitis. suspicion of such a complication indicates a laparotomy.
A sequela of the conservatively managed cases is colonic stenosis.

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