Category Archives: Gastrointestinal

Tip 29: NEC surgery

The main indications for surgery in NEC are: failure to respond to medical management, formation of a mass, perforation. Reference: Rees, C.M., Hall, N.J., Eaton, S., et al. 2005. Surgical strategies for necrotising enterocolitis: a survey of practice in the United … Continue reading

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Tip 28: NEC stages

The modified Bell’s stages for NEC are: 1 (suspected) – general features of sepsis, mild abdo distension, increased NG asp, AXR: normal/mild ileus. 2a (confirmed) – prominent abdo distension, bloody stools, mild abdo tenderness, AXR: thickened bowel wall, focal pneumatosis. … Continue reading

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Tip 20: ADEPT

ADEPT is the Abnormal Doppler Enteral Prescription Trial (2012, 404 babies). The main finding was that there was no benefit to delayed initiation of feeds (5 – 6 days of age) vs. early initiation of feeds (24 – 48h age) in … Continue reading

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Tip 238: meconium plug syndrome

A meconium plug causing intestinal obstruction is usually benign and clears after rectal stimulation or contrast enema.  If regular bowel movement does not occur afterwards, a rectal biopsy is recommended to look for Hirschprung’s disease. Meconium plug syndrome is not the … Continue reading

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Tip 213: anorectal malformations 2

Anorectal malformations can be associated with other congenital anomalies such as : CHARGE (Coloboma, Heart defects, Atresia of the nasal choanae, Retardation of growth, Genital or urinary abnormalities, Ear abnormalities) VACTERL (Vertebral anomalies, Anal atresia, Cardiac defects, Tracheo-Esophageal fistula, Renal anomalies, Limb defects). Reference: Levitt, M. A., & Peña, A. (2007). Anorectal … Continue reading

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Tip 212: anorectal malformations

These are a wide spectrum of disorders affecting 1 in 5000 live births. The more proximal the lesion, the more complex the surgical input required. Reference: Levitt, M. A., & Peña, A. (2007). Anorectal malformations. Orphanet J Rare Dis, 2(33), 1-13. Previously published: … Continue reading

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Tip 208: duodenal atresia 2

Duodenal atresia occurs in 1 per 5,000 – 10,000 live births, involving male infants more commonly than female infants. Down syndrome occurs in ~25%; congenital heart disease occurs in ~20%. Reference: Kimura, K. (2000). Bilious Vomiting in the Newborn: Rapid Diagnosis … Continue reading

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