Monday, 2 December 2013

Modified Bell’s Staging Criteria for Necrotizing Enterocolitis

Stage 1 : 1a - mild abdominal distension+                          occult blood in stools
               1b - 1a+gross blood in stools
Stage 2 : 2a - mildly ill - stage 1+ absent    bowel sounds and mild abdominal tenderness
                2b - moderately ill - 2a+ cellulitis and right lower quadrant mass
Stage 3 : 3a - severely ill and intact bowel - stage 2 + marked distension and signs of generalised peritonitis
                3b - 3a + bowel perforated

Management:
Stage 1 : NPO + antibiotics for 3 days
Stage 2 : 2a - NPO + antibotics for 7 - 10days
                2b - NPO + antibiotics for 14 days
Stage 3 : 3a - NPO + antibiotics for 14days, ionotrpic support and ventilator support
                3b - 3a + surgery

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