Hi, this is Tom, and in this episode I'm going to be going through necrotizing entropolytis.

And you can find notes at zero to finals.com slash NEC and in the zero to finals pediatrics book.

And you can find flashcards and questions at

members.0.0.0.com. So let's jump straight in. Necrotizing entrolitis, or NEC, is a disorder

affecting premature neonates, where part of the bowel becomes necrotic.

Necrosis refers to death of the tissue.

It's life-threatening due to the risk of bowel perforation, leading to peritonitis, sepsis, and shock.

The cause of necrotizing enterocolitis is unclear.

There are certain risk factors for developing the condition, which include being

very low birth weight under 1.5 kilograms, very or extremely premature before 32 weeks gestation, formula feeding and the conditions

less common in breast milk fed babies, respiratory distress syndrome and assisted ventilation,

sepsis and having a patent ductus arteriosis.

Let's go through the presentation.

Clinical features that can indicate necrotizing enterocolitis include intolerance to feeds,

vomiting, particularly with green bile, being generally unwell, a distended tender abdomen, absent bowel sounds on auscultation, and blood in the

stool. Infants with bowel perforation will be severely unwell with peritonitis and shock.

Next let's go through investigations.

Blood tests include a full blood count, which may show thrombocytopeniaia or low platelets, and neutropenia, or low

neutrophils, a CRP, which is raised with inflammation, a capillary blood gas may show metabolic

acidosis, and blood cultures are used to identify sepsis.

Abdominal x-ray is the initial imaging investigation for diagnosis. The main view is

anterior posterior, which is where the infant is lying supine on their back and the x-ray is taken

...