Category Archives: Gastrointestinal

Tip 148: meconium ileus

Meconium ileus is due to obstruction of the terminal ileum with thick, viscid meconium. It has an incidence of 1: 1,000 – 2,000 live births. 80 – 90% of neonates with meconium ileus will have cystic fibrosis (usually the first … Continue reading

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Tip 146: NEC risk factors (2)

Other risk factors for NEC include: Hypoxic insult – especially in the more mature infant with NEC Anaemia / need for transfusion Polycythaemia Dehydration Use of non-human milk or hyperosmolar feeds (e.g. fortifier additives) Rapid introduction and escalation of enteral … Continue reading

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Tip 145: NEC risk factors

The aetiology of NEC is multifactorial. The most important risk factors include: Prematurity – median gestation of 29/40 Low birth weight, especially <1500g (found in 65% of cases in one study) In-utero growth restriction (IUGR) Patent ductus arteriosus (PDA) Formula … Continue reading

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Tip 130: ranitidine in preterm babies

There is a strong statistical evidence to suggest that ranitidine increases the risk of both NEC and infection in preterm infants, but none of the data so far comes from an RCT. References: Chandrasekaran M., Fleming P. (2014). Question 1: does … Continue reading

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Tip 98: gastroschisis

Compared to infants with simple gastroschisis (intact, uncompromised, continuous bowel), those with complex gastroschisis (bowel perforation, necrosis, or atresia): took longer to reach full enteral feeding; required a longer duration of parenteral nutrition; required a longer stay in hospital; were more likely to … Continue reading

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Tip 97: malrotation 2

The majority of children with malrotation do not have any predisposing syndrome or genetic susceptibility, though it is invariably present in children with congenital diaphragmatic hernia, gastroschisis and exomphalos. Reference: Strouse, P. J. (2004). Disorders of intestinal rotation and fixation (“malrotation”). Pediatric … Continue reading

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Tip 94: malrotation

Intestinal malrotation occurs in approximately 1 in 500 live births. ~80% will present in the first month of life and most of those will be in the first week, classically with bilious vomiting. Reference: Strouse, P. J. (2004). Disorders of intestinal rotation … Continue reading

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