Abdominal Distention and Emesis in a Term Neonate

Area of Science:

• Neonatology
• Pediatric Surgery
• Emergency Medicine

Background:

• Necrotizing enterocolitis (NEC) is a critical gastrointestinal condition primarily affecting preterm infants, but also occurring in term neonates.
• A rare, rapidly fatal form, NEC totalis, affects nearly 10% of NEC cases.
• This case highlights NEC in a term infant without known risk factors.

Observation:

• A 24-day-old term infant presented with emesis, abdominal distension, tachycardia, and hypotension.
• Initial imaging was inconclusive, delaying diagnosis.
• The infant's condition rapidly deteriorated, necessitating exploratory laparotomy.

Findings:

• The infant was diagnosed with NEC totalis, a severe form of necrotizing enterocolitis.
• Despite aggressive management, the infant passed away within 6 days.
• This case underscores the diagnostic challenges of NEC in term infants.

Implications:

• Emergency physicians must consider NEC in term infants with severe gastrointestinal distress, even without typical risk factors.
• Prompt fluid resuscitation, antibiotics, and surgical consultation are vital.
• Timely diagnosis and intervention are critical for improving outcomes in neonatal gastrointestinal emergencies.