Necrotizing enterocolitis (staging)

siehe auch

Pneumoperitoneum
Pneumatosis intestinalis
Nekrotisierende Enterokolitis
portalvenöses Gas

Necrotizing enterocolitis (NEC) can be staged into three groups, to guide appropriate treatment based on the work of Bell et al. . In general, stage I and II are managed medically whereas stage III is managed surgically.

stage I
- clinical signs
  - lethargy, temperature instability, apnea, bradycardia
  - emesis, abdominal distension, hematochezia
- radiographic findings
  - intestinal dilatation
- treatment
  - oral feeding cessation
  - parenteral nutrition
  - nasogastric tube suction
  - antibiotics
stage II
- IIa: mildly ill
- IIb: moderately ill
- clinical signs
  - as in stage I
  - metabolic acidosis, thrombocytopenia
  - abdominal tenderness, absent bowel signs
- radiographic findings
  - intestinal dilatation
  - portal venous gas
  - pneumatosis intestinalis
- treatment
  - as in stage I
  - correction of metabolic acidosis
stage IIIa: shock
- clinical signs
  - as in stage II
  - respiratory or circulatory arrest
- radiographic findings
  - as in stage II
  - ascites
- treatment
  - inotropes, etc.
  - as in stage II
stage IIIb: perforation
- clinical signs: any
- radiographic findings: pneumoperitoneum
- treatment: surgery