Necrotizing enterocolitis can be observed in about 5% of children who have entered the intensive care unit in an emergency. Such a disease is manifested in premature babies who have pronounced intrauterine hypoxia before the moment of birth. Necrotizing colitis is pathological in nature and is considered very dangerous, so the child is required to provide immediate medical attention.
The etiology of ulcerative enterocolitis is still not clear. In the modern medical community, it is commonly believed that it is mainly seen in premature infants, as well as in infants who have suffered asphyxia during childbirth. An equally common cause may be a respiratory system disorder. An important role in necrotizing enterocolitis in children is given to the presence of pathologies in the mother during pregnancy.
Symptoms of ulcerative enterocolitis
This disease is characterized by an acute onset, and signs can appear no earlier than 5 days after the birth of the child. Symptoms of necrotizing enterocolitis in newborns are reduced to:
- Vomiting when injected with bile.
- Discharge from the cavity of the rectum, which is very similar to blood.
If such signs are observed, it is quite possible the manifestation of a peptic ulcer, and immediate examination and necessary therapeutic manipulations should be made. In the absence of care, this form of necrotizing enterocolitis can be characterized by a severe type of system and radiologic pattern throughout the day - one and a half.
In the case of the state of preperforation, premature infants with necrotic enterocolitis will have a marked type of pain in the course of the colon cavity. In some cases, an examination of the palpation determines the infiltration. Due to X-ray examinations, it is possible to detect pneumatosis, that is, swelling of the intestinal walls.
In the case that in newborns with necrotic enterocolitis there is such a symptom as perforation of the intestinal walls, everything will point to cystic pneumatosis. Due to the rapid development of necrosis of intestinal walls, perforation has the property to manifest itself several hours after the first signs began to appear.
Ulcerative necrotic colitis is observed in premature infants whose body weight at birth is not less than 1500 g. The disease begins to develop at 2-4 weeks of life with pronounced signs in the peritoneal cavity. In addition to the occurrence of flatulence, vomiting and loss of appetite. In addition, common signs of peptic ulcer and intoxication of the body can also join, which lead to the dysfunction of vital organs and systems.
With progressive necrotizing enterocolitis in newborns, erythema and edema of the peritoneal walls are manifested, with the growing tension of the abdominal muscles. When performing auscultation in the event of an illness, there will be no noise in peristalsis, however, physical information is very scarce.
Treatment of ulcerative enterocolitis
If newborns have impaired respiratory function, then an additional flow of oxygen or artificial ventilation is provided. In case of violation of hemodynamics in newborns with necrotizing enterocolitis, measures are taken to support blood circulation. To do this, freshly frozen plasma is used in accordance with the calculation of 10 ml / kg of body weight. To normalize the renal and intraorganic blood flow, a low dosage of dopamine is used. If the acid-alkaline homeostasis is disturbed, it becomes necessary to introduce sodium bicarbonate.
Antibiotics as a mandatory component of the treatment of necrotizing ulcerative colitis with a wide range of effects.
Therapy of ulcerative necrotizing enterocolitis is carried out in the conditions of a specialized hospital. Initially, such events will be held:
- Antibiotic therapy.
- Specific detoxification therapeutic procedures.
- Desensitizing and symptomatic therapeutic procedures. In this case, treatment of certain manifestations of necrotizing enterocolitis in newborns is carried out.
- Vitamin therapeutic manipulations.
A child with necrotic ulcerative colitis is placed in a specialized cuvette, where he is given the required amount of oxygen, and alkaline inhalations are performed. Regarding nutrition, it is parenterally or dosed, and the missing amount of fluid is compensated by intravenous administration. Nutrition in children occurs parenterally through the peripheral vein. The transition from this type of food to natural with necrotic enterocolitis, is very long and multi-stage, and depends on how bad the disease is. Vitamin, electrolyte and microelement therapy is included in the scheme of parenteral nutrition with necrotizing enterocolitis immediately at the beginning of treatment.
In the case of perforation in the abdominal cavity of premature infants, a pattern of diffuse peritonitis may appear. When carrying out an X-ray examination with necrotic enterocolitis, the presence of gas in the abdominal cavity will be revealed in newborns, which is the main indicator for surgical intervention.
Modern diagnosis and early care with conservative methods for necrotizing ulcerative colitis in newborns, allows children to save their lives. In addition, intoxication disappears, the stool is normalized, and the infiltrate also resolves.