Necrotizing enterocolitis in full-term neonates. Case report and review of the literature
Authors:
K. Maťašová 1; D. Murgaš 2; M. Zibolen 1
Authors place of work:
Neonatologická klinika JLF UK a UNM, Martin
prednosta prof. MUDr. M. Zibolen, CSc.
1; Klinika detskej chirurgie JLF UK a UNM, Martin
prednosta doc. MUDr. M. Dragula, PhD, mim. prof.
2
Published in the journal:
Čes-slov Pediat 2011; 66 (6): 372-379.
Category:
Case Report
Summary
Necrotizing enterocolitis (NEC) may rarely develop in full-term newborns. NEC in term infants is characterised by the early onset at the age of 2–4 days, the colon is the typical location of inflammation and necrosis. The third difference as compared to preterm babies is the association with previous underlying illness that alters intestinal blood flow. Aetiology of NEC remains poorly understood but the presence of other risk factor, colonisation of the gut with pathogenic microorganisms and enteral feeding seem to be of great importance. Sonographic examination may be helpful for the early diagnosis of patients with NEC as the gas (granular echogenicities) in the bowel wall can be seen in early stage of NEC.
In this report we present a case of a boy born at 36 gestational weeks, his birth weight was 1950 g, Apgar score 10, 10 in the first and fifth minutes, respectively. On the second day antibiotics were indicated due to perinatal infection (colonisation with Escherichia coli, low leukocyte count, low platelet count) with negative blood culture, the baby was hemodynamically stable. At the age of 4 days bloody vomiting appeared, abdominal radiography showed pneumatosis intestinalis – the typical finding for NEC. Despite the treatment 24 hours later pneumoperitoneum appeared, surgical intervention was contraindicated due to untreatable coagulopathy. The baby died at the age of 6 days. At autopsy the presence of extensive NEC with bowel perforation and diffuse peritonitis were confirmed.
Key words:
necrotizing enterocolitis, full-term neonate, pneumoperitoneum, pneumatosis intestinalis
Zdroje
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Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
2011 Číslo 6
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