Residência Pediátrica (Sep 2023)
Enterocolite necrosante neonatal: relato de caso e revisão de literatura
Abstract
Neonatal necrotizing enterocolitis (NEC) is a syndrome characterized by inflammation and ischemic necrosis of the gastrointestinal tract that can course with variable clinical manifestations: such as abdominal distension, bilious vomiting, hematoquezia, frequent gastric waste, decreased hydro-air noises, fecal changes. The condition is usually associated with systemic signs (pallor, apnea, hypoactivity, dysthermias). NEC can manifest with partial intestinal necrosis and have complete recovery, requiring only clinical treatment. Case report: newborn (NB) of T.A.A., female, premature (33 weeks and 5 days), extremely low weight (888g), APGAR 8/9, referred to the Neonatal Intensive Care Unit (ICU NEO). On the 1st day of life, he presented significant abdominal distension and bilious debt by the orogastric tube (SOG). It eliminated meconium after rectal stimulation, with 43 hours of life. He maintained abdominal distension until the 10th day of life, progressing, with progressive improvement (reduction of abdominal distension, change in the aspect of the debt by SOG), after the institution of adequate therapy. On the 11th day of life, he started a minimal enteral diet, progressing gradually, achieving success in diet progression. Enterocolitis is one of the most frequent gastrointestinal emergencies in neonates, most frequently affecting premature newborns, especially those born with very low birth weight. Studies indicate the recent increase in the incidence of NEC in NEO ICUs, in several countries, due to the increased survival of premature newborns. Therefore, there is a need for a greater dissemination of knowledge about the pathology; mainly among health professionals who work in these units.
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