By Brian F. Gilchrist
The literature on NEC (necrotizing Enterocolitis), specifically within the significant textbooks, only recapitulated what have been written some time past; there was no new assistance. NEC was once considered as a fait accompli; a sometimes-dire disorder that used to be to be faced purely after it reared its perfidious head. This monograph asks the reader to reconsider their procedure the NEC. even though, there aren't any compel others to pursue the way to interfere prior to the die has been forged. therefore, this e-book is a promissory word and a problem.
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Extra resources for Necrotizing Enterocolitis
Tapia JL, Ramirez R, Cifuentes J et al. The effect of early dexamethasone administration on bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome. J Pediatr 1998; 132:48-52. 49. Halac E, Halac J, Begue EF et al. Prenatal and postnatal corticosteroid therapy to prevent neonatal necrotizing enterocolitis: a controlled trial. J Pediatr 1990; 117:132-138. 50. Israel EJ, Schiffrin EJ, Carter EA et al. Cortisone strengthens the intestinal mucosal barrier in a rodent necrotizing enterocolitis model.
Contrast evaluation for other suspected illness may illustrate disease in the acute phase and aid assessment of complications in the recovered infant. Ultrasound evaluation has a place although the features suggesting NEC may be found serendipitously rather than by design. Similarly the small portions of the abdomen included on other studies especially the chest x-ray should be reviewed carefully as clues to developing bowel disease may be detected. Indications The indications for evaluation include increased aspirates or residuals from the nasogastric tube, bile stained aspirates, vomiting, constipation or diarrhea, frankly bloody stools, abdominal distension, abdominal discoloration, palpable bowel loops, lethargy, increased apneas and, or bradycardias and other signs of sepsis.
Abscesses tend to present in the acute phase. USS review of the abdominal and pelvic recesses together with assessment of the bowel for fixed masses and fluid collections is the method of choice for evaluation. Strictures often become apparent when feeding is recommenced. Typically these are in distal small bowel or the colon. Investigation usually starts with an enema using a water soluble low osmolar contrast agent such as Isovue 128 (Figs. 23C). This is isotonic. If this fails to reveal an obstruction or stricture then a small bowel study is performed (Fig.