NEC - NECROTIZING ENTEROCOLITIS Janice Nicklay Catalan M.D OBJECTIVES Ability to diagnose and treat the signs and symptoms of NEC Ability to

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NECROTIZING ENTEROCOLITIS Janice Nicklay Catalan M.D.
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OBJECTIVES Ability to diagnose and treat the signs and symptoms of NEC Ability to evaluate radiographs for the classic findings of NEC List several long-term complications associated with NEC
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NECROTIZING ENTEROCOLITIS Epidemiology: most commonly occurring gastrointestinal emergency in preterm infants leading cause of emergency surgery in neonates overall incidence: 1-5% in most NICU’s most common in VLBW preterm infants 10% of all cases occur in term infants
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NECROTIZING ENTEROCOLITIS Epidemiology: 10x more likely to occur in infants who have been fed males = females blacks > whites mortality rate: 25-30% 50% of survivors experience long-term sequelae
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NECROTIZING ENTEROCOLITIS Pathology: most commonly involved areas: terminal ileum and proximal colon GROSS: bowel appears irregularly dilated with hemorrhagic or ischemic areas of frank necrosis focal or diffuse MICROSCOPIC: mucosal edema, hemorrhage and ulceration
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NECROTIZING ENTEROCOLITIS MICROSCOPIC: minimal inflammation during the acute phase increases during revascularization granulation tissue and fibrosis develop stricture formation microthrombi in mesenteric arterioles and venules
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NECROTIZING ENTEROCOLITIS Pathophysiology: UNKNOWN CAUSE…….
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PRIMARY INFECTIOUS AGENTS Bacteria, Bacterial toxin, Virus, Fungus CIRCULATORY INSTABILITY Hypoxic-ischemic event Polycythemia MUCOSAL INJURY ENTERAL FEEDINGS Hypertonic formula or medication
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This note was uploaded on 01/31/2012 for the course PDBIO 305 taught by Professor Woods,a during the Fall '08 term at BYU.

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NEC - NECROTIZING ENTEROCOLITIS Janice Nicklay Catalan M.D OBJECTIVES Ability to diagnose and treat the signs and symptoms of NEC Ability to

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