Necrotizing enterocolitis (staging)
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Necrotising enterocolitis (NEC) can be staged into three groups, helping to guide appropriate treatment. In general, stage I and II are managed medically whereas stage III is managed surgically.
-
stage I
- clinical signs
- lethargy, temperature instability, apnoea, bradycardia
- emesis, abdominal distension, haematochezia
- radiographic findings
-
intenstinal dilationintestinal dilatation
-
- treatment
- oral feeding cessation
- parenteral nutrition
-
NGTnasogastric tube suction - antibiotics
- clinical signs
-
stage II
- IIa: mildly ill
- IIb: moderately ill
- clinical signs
- as in stage I
- metabolic acidosis,
thrombocytopaeniathrombocytopenia - abdominal tenderness, absent bowel signs
- radiographic findings
- intestinal
dilationdilatation - portal venous gas
- pneumatosis intestinalis
- intestinal
- treatment
- as in stage I
- correction of metabolic acidosis
-
stage IIIa: shock
- clinical signs
- as in stage II
- respiratory or circulatory arrest
- radiographic findings
- as in stage II
- ascites
- treatment
- inotropes, etc.
- as in stage II
- clinical signs
-
stage IIIb: perforation
- clinical signs: any
- radiographic findings: pneumoperitoneum
- treatment: surgery
-<li>radiographic findings<ul><li>intenstinal dilation</li></ul>- +<li>radiographic findings<ul><li>intestinal dilatation</li></ul>
-<li>NGT suction</li>- +<li>nasogastric tube suction</li>
-<li>metabolic acidosis, thrombocytopaenia</li>- +<li>metabolic acidosis, thrombocytopenia</li>
-<li>intestinal dilation</li>- +<li>intestinal dilatation</li>
-<li>inotropes, etc</li>- +<li>inotropes, etc.</li>
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