Necrotizing enterocolitis

see video link in second post

A one-week-old 25-week EGA infant on breast milk feeds develops abdominal distention and hypotension. Abdominal plain films reveal distended bowel loops, but no pneumoperitoneum, pneumatosis intestinalis or portal venous gas. The NICU team is interested in decreasing radiation exposure and would like to utilize bowel ultrasound for serial examinations. What findings on ultrasound[size=20px] have been associated with the need for surgery? A Absent peristalsis B Increased bowel wall perfusion C Pneumatosis intestinalis D Portal venous gas E Simple ascites​[/size]

.

[size=20px]An 850 gram infant is receiving medical therapy for necrotizing enterocolitis(NEC). The most reasonable strategy to reduce the likelihood of neurodevelopmental impairment is: A Whole body cooling to 33-34 degrees Celsius B Avoiding an intestinal anastomosis if bowel resection is necessary C Placing a peritoneal drain if pneumoperitoneum occurs D Holding feeds for at least 14 days E Proceeding quickly to laparotomy if there is clinical deterioration[/size]

[size=20px]An ex-25-week premature infant underwent laparotomy, small bowel resection, and end ileostomy with mucus fistula for necrotizing enterocolitis (NEC). She is now 48 weeks corrected gestational age. She is tolerating enteral feeds, gaining weight and has been weaned to room air. The Neonatology teams asks if any additional testing is required prior to ostomy reversal. A Contrast studies are not required prior to ostomy reversal so no further testing is needed​ B Contrast studies are only needed in patients who have difficulty tolerating enteral feeds, so no further testing is needed in this case C Contrast studies should be obtained prior to ostomy rever…

see video link in second post

.

see video link in second post

.

[size=20px]An infant is born at 26 weeks gestational age. Other than using maternal breast milk, the most effective strategy to reduce the risk of necrotizing enterocolitis is: A Delay initiation of enteral feedings for 7 days B Advance enteral feedings by 18 ml/kg/day C Daily administration of Bifidobacteriuminfantis D Enteral administration of metronidazole E Use of pasteurized breast milk​[/size]

[size=20px]A 26-week gestational age 900-gram infant, now 21 days of age, has pneumoperitoneum, extensive pneumatosis, portal vein gas and is on two vasopressors. He is on maximum support with the conventional ventilator, has been resuscitated, and is optimized for surgical treatment according to the neonatology team. Which statement is true regarding his survival and 2-year neurodevelopmental status? A The likelihood for neurodevelopmental impairment in infants with NEC with initial laparotomy or initial peritoneal drain placement is equivalent. B With this gestational age and surgical condition, he has a 90% probability of having some degree of neurodevelopment…

see video link in second post

A 600-gram, 25-week gestational age infant has feeding intolerance, abdominal distention, bloody stools and localized right lower quadrant erythema with pneumatosis on radiograph. He is started on broad spectrum antibiotics, but subsequently develops pneumoperitoneum and an abdominal drain is placed. Twenty-four hours later, he has increasing vasopressor requirements and has stopped making urine. His radiograph is as shown. [size=20px]The next best step in managing this infant with perforated necrotizing enterocolitis is A placing another drain. B changing antibiotic therapy. C laparotomy. D administration of corticosteroids. E administration of pr…

see video link in second post

[size=20px]A 3-day old 900-gm, unfed premature baby suddenly develops abdominal distension. An abdominal X-ray demonstrates intraperitoneal free air, without pneumatosis intestinalis or portal venous gas. An abdominal drain is placed at the bedside, releasing gas and enteric contents. The following day the baby is hemodynamically stable and the enteric drainage has stopped. The most appropriate next step in care is: A observation B laparoscopy C placement of a second drain D laparotomy and primary anastomosis E laparotomy and stoma[/size]

see video link in second post

see in next post

Any one want a high quality PDF of this chart, post in this thread and use a personalized picture as an avatar, I will send it to you in a private message Edit: available without restrictions

[size=20px]Long-term complications of NEC include all of the following except: A short bowel syndrome B bowel stricture C neurodevelopmental problems D stoma-related electrolyte imbalance E inflammatory bowel disease [/size]

First one with correct answer with justification win. A four-day old term newborn with congenital heart disease (atrial and ventricular septal defect) develops feeding intolerance and bloody stools. The abdominal radiograph is pictured below. [size=20px]Which of the following is the next best step in the management of the this full term infant with bloody stools? A switch to a nonmilk based formula B administer a diuretic C start broad spectrum parenteral antibiotics D obtain a contrast enema E perform an exploratory laparotomy[/size]

Saudi pediatric Surgery board lectures, download from next post

7 days old ,PT 36 weeks . W; 1.7 KG. has PDA on paracetamol. was on oral feeding, has get sudden abdominal distension. WBC: 10000, Platelets: 270000. PH: 7.31, HCO3: 25 , abdomen X RAY revaled pneumoperitoneum. How to manage ? [center][/center] Disclaimer: this is not my case, this case from Saudi pediatric surgery club, only to test forums