nec

Views:
 
Category: Education
     
 

Presentation Description

Necrotizing enterocolitis

Comments

Presentation Transcript

Necrotizing enterocolitis : 

Necrotizing enterocolitis NEC BY DR. ABDULLA ALSAID PEDIATRIC SURGEON FRCSI

N E C : 

N E C Is the most frequently neonatal surgical emergency and major cause of morbidity And mortality in the premature infant.

RISK FACTORS : 

RISK FACTORS SEPSIS STRESS RESPIRATORY FAILURE HYPOXIA LOW BIRTH WT. PREMATURE HYPOTENTION

PATHOPHYSIOLOGY : 

PATHOPHYSIOLOGY Hypoxia and hypotension in the premature Leading to uncontrolled splanchnic vasoconstriction causing hypo perfusion and ischemia of the neonatal intestinal tract.

Slide 5: 

More than 90% of cases of NEC occurs after the the , initiation of enteral feeding Normal intestinal flora becomes opportunistic facing intestinal mucosal injury. Forming intramural gas dissecting the wall causing ischemia with end result of gangrene and perforation.

HITOPATHOLOGICAL FEATURES : 

HITOPATHOLOGICAL FEATURES Sub mucosal edema hemorrhage micro vascular thrombosis Trasmural necrosis Intramural gas

THE MOST COMMON SITES : 

THE MOST COMMON SITES

STAGES OF NEC : 

STAGES OF NEC Stage 1 (suspected) -Risk factors -low grad fever -poor feeding -abdominal distension -occult blood

Slide 9: 

Stage 11 (definitive) The above + pneumatosis intestinalis portal venous gas abdominal distension gross blood with stool

Slide 10: 

Stage 111 (advanced) The above + septic shock marked GIT bleeding pneumoperitonium abdominal mass cellulites of abdominal wall

CLASSIC SIGNS : 

CLASSIC SIGNS Abdominal distention Feeding intolerance Bilious vomiting In stool Occult or gross blood

MANAGEMENT : 

MANAGEMENT DIAGNOSIS non complicated complicated TREATMENT medical surgical

DIAGNOSIS : 

DIAGNOSIS Early diagnosis of NEC Complicated NEC

TREATMENT : 

TREATMENT MEDICAL NPO ANTIBIOTICS TPN SURGICAL

Absolute indications for surgery : 

Absolute indications for surgery Failure of medical treatment Pneumoperitonium Vague abdominal mass Erythema of abdominal wall

Abdominal x-ray : 

Abdominal x-ray