Necrotizing Enterocolitis

DEFINITION

Necrotizing enterocolitis is a condition in which the inner lining of the intestinal injury and inflammation. If the disease is severe, partial intestinal tissue may die (become necrotic) and cause intestinal perforation and peritonitis.

Necrotizing enterocolitis is most common in premature infants. Necrotizing enterocolitis is a serious situation, with a mortality rate of nearly 25%.

CAUSE

The cause is unknown, but thought to be caused by reduced blood flow to the intestine so that the intestines can not produce mucus, which normally serves to protect the intestinal lining. Other factors are also thought to play a role is the bacteria in the gut. Bacteria can enter the intestinal wall is damaged and cause gas in it. Bacteria can even enter the bloodstream and cause infection (sepsis).

If the damage to the intestine to grow until the entire thickness of the bowel wall and tear occurs in the intestinal wall, then the contents of the gastrointestinal tract can get out into the abdominal cavity and cause inflammation and infection usually occurs in the abdominal cavity and the lining (peritonitis).

Risk factor enterocolitis nekrotisans:

·         Premature babies

·         Infants who received formula milk too thick

·         Babies who were in the treatment room, where there is an outbreak of this disease

·         Babies who underwent exchange transfusion

SYMPTOMS

Nektrotikans symptoms of enterocolitis in infants can include:

- bloated

- Vomiting green

- There can be blood in the stool

- Severely ill and looked listless

- Body temperature is low and unstable

- Could happen stopping breathing attack

- Do not want to eat

- diarrhea

Complications:

·         Bowel perforation (a hole in the intestines)

·         Sepsis (blood infection)

·         Peritonitis (inflammation of the stomach lining)

·         Narrowing of the intestine that can cause a blockage in the gastrointestinal tract

·         Shock

DIAGNOSIS

Diagnosis is based on symptoms and examination results, among others:

- Abdominal X-ray photograph (indicate the presence of gas in the intestinal wall or the presence of free air in the abdominal cavity, if the intestinal wall is perforated)

- Blood test in the stool

- A blood test to see if there are bacteria and other indicators of sepsis

TREATMENT

In case of necrotizing enterocolitis, then feeding should be discontinued. The air inside the intestine will be removed through a small tube inserted into the stomach. As a substitute for milk or breast milk, given fluids intravenously.

In case of intestinal perforation or peritonitis, it is necessary to surgery. Surgery may also be necessary if the baby's condition worsened, although it has been treated. Damaged intestinal tissue is cut and removed and a colostomy or iliostomi (where the ends of the intestine connected to the stomach wall for a while, so that the dirt will come out of the hole in the abdominal wall). Reconnection of the intestine was a few weeks or a few months later after infection and inflammation subsides.

REFERENCE

- E, Todd. Necrotizing enterocolitis. Medline Plus. 2011.

- K, Arthur E. Necrotizing enterocolitis. Merck Manual Home Health Handbook. 2009.

- R, J. Fernando. Necrotizing enterocolitis. Kids Health. 2011.