Abstract
Necrotizing enterocolitis (NEC) is a gastrointestinal emergency most commonly seen in premature infants, but equally important to recognize in term infants. Early diagnosis and management is critical to achieving optimal patient outcomes. This report outlines a simulation of the challenging scenario of a term infant presenting to the emergency center with NEC as a result of bacteremia and sepsis due to a urinary tract infection (UTI). This simulation can be used for teaching different levels of learners including novice, intermediate, and advanced. It focuses on the presentation, diagnosis, and emergent management of NEC, and additionally incorporates Pediatric Advanced Life Support (PALS) for more advanced learners.
Highlights
Necrotizing enterocolitis (NEC) is the most common acquired gastrointestinal emergency in the newborn infant, with significant morbidity and mortality
90% of cases of NEC occur in preterm infants, with an incidence of about 12% in infants weighing less than 1500 grams at birth
: 2. Demonstrate skills appropriate for initial management of NEC including placement of replogle tube
Summary
Necrotizing enterocolitis (NEC) is the most common acquired gastrointestinal emergency in the newborn infant, with significant morbidity and mortality. 90% of cases of NEC occur in preterm infants, with an incidence of about 12% in infants weighing less than 1500 grams at birth. About 10% of NEC cases occur in full-term babies (gestational age greater than 37 weeks) [1]. Received 09/08/2020 Review began 10/14/2020 Review ended 01/04/2021 Published 01/10/2021. The classic presentation often starts with a change in feeding tolerance and progresses to other abdominal symptoms and signs (including distention, tenderness, vomiting, hematochezia, and absent bowel sounds), along with non-specific systemic signs (including lethargy, apnea, temperature instability, and jaundice). Abdominal exam may reveal abdominal distension, discolored skin overlying the abdomen, or visible bowel loops
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