Podcast 645: Necrotizing Enterocolitis and More

Podcast 645: Necrotizing Enterocolitis and More

Contributor: Peter Bakes, MD

Educational Pearls:

  • Necrotizing Enterocolitis (NEC)
    • Presents in the first few days of life (often in the NICU) to 3 weeks old
    • Risk factors include prematurity, excess feeding, neonatal sepsis
    • Pneumatosis Intestinalisis on abdominal xray caused by bacterial translocation into the bowel wall
    • Treated with NG tube, bowel rest and surgical resection
  • Other causes of pediatric abdominal pain
    • Malrotation with volvulus
      • Malrotation is caused by failure of intestinal rotation in the 8th-12th week of development
      • Presents with bilious vomiting, which is a surgical emergency in a neonate
      • 90% of cases present in the first year of life, with most of these presenting in the first month
      • Diagnosed with an upper GI series
    • Pyloric Stenosis
      • Typically in males <2 months of age who present with signs of dehydration in the setting of non-bilious vomiting
      • Diagnosed with abdominal ultrasound and treated surgically
    • Intussusception
      • Typically presents between 2 months and 2 years with a palpable mass in the RUQ
      • Diagnosed with abdominal ultrasound
    • Duodenal atresia
      • Congenital stricture in the duodenum
      • Presents with bilious vomiting and a double-bubble on abdominal xray

References

Alwan R, Drake M, Gurria Juarez J, Emery KH, Shaaban AF, Szabo S, Sobolewski B. A Newborn With Abdominal Pain. Pediatrics. 2017 Nov;140(5):e20164267. doi: 10.1542/peds.2016-4267. PMID: 29042421.

Hostetler MA, Schulman M. Necrotizing enterocolitis presenting in the Emergency Department: case report and review of differential considerations for vomiting in the neonate. J Emerg Med. 2001 Aug;21(2):165-70. doi: 10.1016/s0736-4679(01)00371-7. PMID: 11489407.

Summarized by John Spartz, MS3

Jaksot(1145)

Episode 905: Oseltamivir (Tamiflu) for Influenza

Episode 905: Oseltamivir (Tamiflu) for Influenza

Contributor: Aaron Lessem MD Educational Pearls:  Oseltamivir (Tamiflu) is an antiviral medication used commonly to treat influenza Trials show that the medication reduces the duration of illness ...

27 Touko 20242min

Episode 904: Cardiovascular Risks of Epinephrine

Episode 904: Cardiovascular Risks of Epinephrine

Contributor: Aaron Lessen MD Educational Pearls: Epinephrine is essential in the treatment of anaphylaxis, but is epinephrine dangerous from a cardiovascular perspective? A 2024 study in the Journal o...

20 Touko 20242min

Episode 903: Treating Precipitated Opioid Withdrawal

Episode 903: Treating Precipitated Opioid Withdrawal

Contributor: Aaron Lessen MD Educational Pearls: Opioid overdoses that are reversed with naloxone (Narcan), a mu-opioid antagonist, can precipitate acute withdrawal in some patients Treatment of o...

13 Touko 20242min

Episode 902: Liver Failure and Cirrhosis

Episode 902: Liver Failure and Cirrhosis

Contributor: Travis Barlock MD Educational Pearls: How do you differentiate between compensated and decompensated cirrhosis? Use the acronym VIBE to look for signs of being decompensated. V-Volume ...

6 Touko 20243min

Episode 901: Underdosing in Status Epilepticus

Episode 901: Underdosing in Status Epilepticus

Contributor: Aaron Lessen MD Educational Pearls: Lorazepam (Ativan) is dosed at 0.1 mg/kg up to a maximum of 4 mg in status epilepticus Some ED protocols only give 2 mg initially The maximum r...

29 Huhti 20242min

Episode 900: Ketamine Dosing

Episode 900: Ketamine Dosing

Contributor: Travis Barlock MD Educational Pearls: Ketamine is an NMDA receptor antagonist with a wide variety of uses in the emergency department. To dose ketamine remember the numbers 0.3, 1, and 3....

22 Huhti 20242min

Episode 899: Thrombolytic Contraindications

Episode 899: Thrombolytic Contraindications

Contributor: Travis Barlock MD Educational Pearls: Thrombolytic therapy (tPA or TNK) is often used in the ED for strokes Use of anticoagulants with INR > 1.7 or  PT >15 Warfarin will reliably i...

15 Huhti 20243min

Episode 898: Takotsubo Cardiomyopathy

Episode 898: Takotsubo Cardiomyopathy

Contributor: Ricky Dhaliwal, MD Educational Pearls: Takotsubo cardiomyopathy, also known as "broken heart syndrome," is a temporary heart condition that can mimic the symptoms of a heart attack, inc...

10 Huhti 20243min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
radio-antro
utelias-mieli
rss-sosiopodi
ihanat-ipanat
mielipaivakirja
filocast-filosofian-perusteet
rss-bios-podcast
rss-laakaripodi
rss-radplus
rss-opeklubi