Abdominal Teaching

• What is classed a recurrent abdominal pain?


  3 or more episodes of abdo pain in past 3 months
• What is necrotising enterocolitis?

  Severe GI disease

  Primarily affects premature infants

  Characterised by necrosis of intestine due to ischaemia & infection -> severe illness & sometimes perforation of bowel
• What are the RFs of necrotising enterocolitis?

  Prematurity

  Low birth weight

  Non-breast-milk feeds

  Sepsis

  Acute hypoxia

  Poor intestinal perfusion

  Congenital heart disease

  Intrauterine growth restriction

  Maternal drugs use

  HIV infection
• What are the signs & symptoms of necrotising enterocolitis?

  Vomiting (may be bilious)

  Feed intolerance

  Bloody stools (may be loose)

  Abdo distension

  Absent bowel sounds

  Signs of systemic compromise (acidosis & resp distress)
• What are the DDx of necrotising enterocolitis?

  Sepsis

  Gastroenteritis

  Intestinal malrotation with volvulus

  Hirschsprung's disease
• What are the Inx for necrotising enterocolitis?

  Obs

  Full Hx & examination

  Bloods (VBG/CBG)

  Abdominal XR

  Abdo USS
• What is the management of necrotising enterocolitis?

  Nil by mouth -> NG tube

  Broad spec Abx

  IV fluids & ventilation

  Surgery -> resection of necrotic sections of bowel
• How can necrotising enterocolitis be prevented?

  Encouraging breastfeeding

  Delayed cord clamping in delivery

  Antenatal corticosteroids (in expectant mothers at risk of preterm labour)

  Caffeine citrate in preterm infants -> prevents bronchopulmonary dysplasia
• What are the possible complications of necrotising enterocolitis?

  Perforation

  Peritonitis

  Short bowel syndrome -> following surgical intervention

  Sepsis & shock

  Disseminated intravascular coagulopathy

  Abscess formation
• When does infantile colic normally resolve?

  Around 6 months of age