What are Some of the Complications of Short Bowel Syndrome?
Discussion
Necrotizing enterocolitis (NEC) is one of the most common gastrointestinal emergencies in neonates. Mortality rates are from 0-45% depending on infant weight and gestation with more premature and smaller infants having greater mortality. NEC usually occurs in premature infants but it also occurs in term infants. The etiology is unknown but is probably multifactorial with ischemia and/or reperfusion playing some role. There are ‘outbreaks’ of NEC but no causative organism has been identified. Regardless of the originating cause, inflammation of the intestine and release of inflammatory mediators causes various degrees of damage to the intestine. Patients who had a history of surgically treated NEC have an increased risk of neurodevelopmental disabilities such as the patient above. Treatment includes stopping gastric feeding, antibiotics, possible surgery and other supportive measures such as treatment for hypotension and respiratory failure.
Presenting signs of NEC can be subtle but can include:
Feeding intolerance
Delayed gastric emptying
Apnea
Abdominal distention and/or tenderness
Bleeding diathesis
Blood in the stool – obvious or occult
Decreased bowel sounds – i.e. ileus
Erythema of the abdominal wall
Lethargy
Shock and/or poor perfusion
Abnormal laboratory testing can include metabolic acidosis, hyponatremia, leukocytosis or leukopenia or thrombocytopenia.
Intestinal failure is a broad term that includes short bowel syndrome (SBS – 80% of cases) bu...
Source: PediatricEducation.org - Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
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