Study note

Necrotizing enterocolitis: presentation and modified Bell staging

THE CONTEXT

Necrotizing enterocolitis (NEC) often affects preterm infants born before 32 weeks of gestation and can resemble neonatal sepsis.

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Abdominal distension, apnea, bradycardia, temperature instability, cyanosis, and lethargy can make NEC mimic neonatal sepsis.

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Stage I includes mild abdominal distension, pre-feed residuals, apnea, temperature instability, and occult or frank blood in stools.

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Stage II includes gross abdominal distension and tenderness. Radiography shows pneumatosis intestinalis, meaning gas in the intestinal walls.

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Stage III adds shock and ascites to the preceding findings. Radiography shows ascites and pneumoperitoneum.

NEETx

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