Pub Date : 1900-01-01DOI: 10.25060/residpediatr-2021.v11n3-216
Luiz Reis Júnior, A. Mendes, C. Ramos
INTRODUCTION: Chikungunya fever is an arbovirus caused by the chikungunya virus (CHIKV). It is one of the main differential diagnoses of dengue, due to characteristic fever and arthralgia. CASE REPORT: An 8-year-old Black male patient had a history of abdominal pain associated with daily fever, odynophagia and asthenia. It evolved over the days with myalgia and polyarthralgia. He was then admitted for investigation. Maintained clinical worsening with persistent fever and increased abdominal pain. After 8 days of hospitalization showed signs of intestinal perforation and septic shock. After surgery and stabilization, he underwent serology and confirmed CHIKV infection by Elisa. DISCUSSION: Most individuals infected with the chikungunya virus develop symptomatic infection (70%). High values compared to other arboviruses. The signs and symptoms are clinically similar to those of dengue fever - acute onset fever, arthralgia and myalgia, headache, nausea, fatigue and rash. Some cases may develop atypically, characterized by the appearance of signs of severity or by presenting less frequent clinical manifestations, such as those in this case. The frequency of severe frames is 0.3%. CONCLUSION: Less common manifestations may occur, and pediatricians should be alert and consider CHIKV infection as a differential diagnosis.
{"title":"Acute abdomen as atypical manifestation of chikungunya","authors":"Luiz Reis Júnior, A. Mendes, C. Ramos","doi":"10.25060/residpediatr-2021.v11n3-216","DOIUrl":"https://doi.org/10.25060/residpediatr-2021.v11n3-216","url":null,"abstract":"INTRODUCTION: Chikungunya fever is an arbovirus caused by the chikungunya virus (CHIKV). It is one of the main differential diagnoses of dengue, due to characteristic fever and arthralgia. CASE REPORT: An 8-year-old Black male patient had a history of abdominal pain associated with daily fever, odynophagia and asthenia. It evolved over the days with myalgia and polyarthralgia. He was then admitted for investigation. Maintained clinical worsening with persistent fever and increased abdominal pain. After 8 days of hospitalization showed signs of intestinal perforation and septic shock. After surgery and stabilization, he underwent serology and confirmed CHIKV infection by Elisa. DISCUSSION: Most individuals infected with the chikungunya virus develop symptomatic infection (70%). High values compared to other arboviruses. The signs and symptoms are clinically similar to those of dengue fever - acute onset fever, arthralgia and myalgia, headache, nausea, fatigue and rash. Some cases may develop atypically, characterized by the appearance of signs of severity or by presenting less frequent clinical manifestations, such as those in this case. The frequency of severe frames is 0.3%. CONCLUSION: Less common manifestations may occur, and pediatricians should be alert and consider CHIKV infection as a differential diagnosis.","PeriodicalId":338092,"journal":{"name":"Residência Pediátrica","volume":"153 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115315835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.25060/residpediatr-2023-884
Inês Rua, Marta Vidal, J. Calvão, Rui Castelo, Leonor Ramos
Newborns may develop blisters and erosions due to multiple entities, including infections, congenital or hereditary diseases. In this report we describe a male newborn who presented with pustular lesions on the first day of life and progressively developed blisters and erosions. Due to disease progression even with intravenous antibiotic therapy after suspicion of bullous impetigo, other diagnoses had to be considered and a multidisciplinary approach with the support of dermatology was necessary. A skin biopsy and genetic study were performed, which allowed the definitive diagnosis of Epidermolysis Bullosa, a group of rare hereditary bullous diseases. Because of the absence of curative therapy, supportive treatment was performed, which did not prevent the patients death at 2 months of life. It is therefore essential for pediatricians to identify this entity as early as possible in order to improve the prognosis
{"title":"A rare and fatal cause of blisters in a newborn","authors":"Inês Rua, Marta Vidal, J. Calvão, Rui Castelo, Leonor Ramos","doi":"10.25060/residpediatr-2023-884","DOIUrl":"https://doi.org/10.25060/residpediatr-2023-884","url":null,"abstract":"Newborns may develop blisters and erosions due to multiple entities, including infections, congenital or hereditary diseases. In this report we describe a male newborn who presented with pustular lesions on the first day of life and progressively developed blisters and erosions. Due to disease progression even with intravenous antibiotic therapy after suspicion of bullous impetigo, other diagnoses had to be considered and a multidisciplinary approach with the support of dermatology was necessary. A skin biopsy and genetic study were performed, which allowed the definitive diagnosis of Epidermolysis Bullosa, a group of rare hereditary bullous diseases. Because of the absence of curative therapy, supportive treatment was performed, which did not prevent the patients death at 2 months of life. It is therefore essential for pediatricians to identify this entity as early as possible in order to improve the prognosis","PeriodicalId":338092,"journal":{"name":"Residência Pediátrica","volume":"210 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116863102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.25060/residpediatr-2023.v13n1-912
Weldes Francisco da Silva Júnior, Lara Oliveira, Maria Cirilo, Driele Almeida, A. C. Cordeiro, Lara Ferreira, R. Pinto
INTRODUCTION: Food is a triggering factor for irritable bowel syndrome (IBS) symptoms. One therapeutic management option that has had beneficial effects is a low-FODMAP diet (acronym for fermentable oligosaccharides, disaccharides, monosaccharides and polyols). OBJECTIVE: To analyze the efficacy and effects of a low-FODMAP diet in pediatric patients with IBS. METHODS: Systematic review using data from PubMed, SciELO and BVS using the descriptors “(Irritable bowel syndrome) AND (FODMAP)”, age filter from 0 to 18 years, in English, Portuguese and Spanish, with a 10-year temporal filter. Duplicate articles, articles not in agreement with the theme and non-scientific work were excluded. RESULTS AND DISCUSSION: 445 articles were found, but only 3 articles were selected among the eligibility criteria. The studies analyzed make comparisons between the test group and the placebo group, or compare children on a typical American infant diet with a reduced FODMAP diet. It is evident that the low FODMAP diet reduces the symptoms of IBS, but it has factors that make it difficult to be practicable, such as: difficulty in being taught and understood, high cost, impact on the intestinal microbiota, presence of side effects such as constipation, in addition to the impact psychological impact of these restrictions for this age group. CONCLUSION: A low-FODMAP diet is a therapy that alleviates the clinical conditions manifested in IBS, but its applicability is limited. More clinical and experimental studies are needed in order to establish whether the benefits of inserting this restrictive diet outweigh the possible harms.
{"title":"Effects of the fodmap diet in children and adolescents with irritable bowel syndrome - systematic review","authors":"Weldes Francisco da Silva Júnior, Lara Oliveira, Maria Cirilo, Driele Almeida, A. C. Cordeiro, Lara Ferreira, R. Pinto","doi":"10.25060/residpediatr-2023.v13n1-912","DOIUrl":"https://doi.org/10.25060/residpediatr-2023.v13n1-912","url":null,"abstract":"INTRODUCTION: Food is a triggering factor for irritable bowel syndrome (IBS) symptoms. One therapeutic management option that has had beneficial effects is a low-FODMAP diet (acronym for fermentable oligosaccharides, disaccharides, monosaccharides and polyols). OBJECTIVE: To analyze the efficacy and effects of a low-FODMAP diet in pediatric patients with IBS. METHODS: Systematic review using data from PubMed, SciELO and BVS using the descriptors “(Irritable bowel syndrome) AND (FODMAP)”, age filter from 0 to 18 years, in English, Portuguese and Spanish, with a 10-year temporal filter. Duplicate articles, articles not in agreement with the theme and non-scientific work were excluded. RESULTS AND DISCUSSION: 445 articles were found, but only 3 articles were selected among the eligibility criteria. The studies analyzed make comparisons between the test group and the placebo group, or compare children on a typical American infant diet with a reduced FODMAP diet. It is evident that the low FODMAP diet reduces the symptoms of IBS, but it has factors that make it difficult to be practicable, such as: difficulty in being taught and understood, high cost, impact on the intestinal microbiota, presence of side effects such as constipation, in addition to the impact psychological impact of these restrictions for this age group. CONCLUSION: A low-FODMAP diet is a therapy that alleviates the clinical conditions manifested in IBS, but its applicability is limited. More clinical and experimental studies are needed in order to establish whether the benefits of inserting this restrictive diet outweigh the possible harms.","PeriodicalId":338092,"journal":{"name":"Residência Pediátrica","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120957685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.25060/residpediatr-2023-623
C. Rocha, Maisa Sohn, F. Moreschi, Daniel Almeida do Valle, Mara Santos, Vitor Palazzo
22q11.2 Deletion Syndrome is the commonest microdeletion syndrome in humans and has a wide spectrum of clinical manifestations, such as craniofacial dysmorphism, airway malformations, heart disease, renal malformations, hypoparathyroidism, neurological and behavioral disorders, immunodeficiencies Residência Pediátrica; 2023: Ahead of Print DOI: 10.25060/residpediatr-2023-623 Nota aos leitores: pode haver informações pendentes, por se tratar de um artigo em “visualização pré-publicação”. and anomalies of the thymus. The broad phenotype spectrum makes the diagnosis more challenging, and an early identification allows not only the evaluation of comorbidities and interventions, but also adequate genetic counseling. Hypoparathyroidism manifested by symptomatic hypocalcemia is one of the clinical presentations of 22q11.2 Deletion Syndrome. This clinical case shows the diagnosis of 22q11.2 Deletion Syndrome in an 11-year-old child with symptomatic hypocalcemia and emphasizes the possibility of a late diagnosis of 22q11.2 Deletion Syndrome.
22q11.2缺失综合征是人类最常见的微缺失综合征，具有广泛的临床表现，如颅面畸形、气道畸形、心脏病、肾脏畸形、甲状旁腺功能低下、神经和行为障碍、免疫缺陷Residência Pediátrica;2023:提前打印DOI: 10.25060/ residenpediatrics -2023-623 Nota aos leitores: pode haver informações pendentes, por se tratar de um artigo em“visualiza”。以及胸腺的异常。广泛的表型谱使诊断更具挑战性，早期识别不仅可以评估合并症和干预措施，还可以进行充分的遗传咨询。以症状性低钙为表现的甲状旁腺功能减退是22q11.2缺失综合征的临床表现之一。本临床病例显示了一名11岁症状性低钙儿童的22q11.2缺失综合征的诊断，并强调了22q11.2缺失综合征晚期诊断的可能性。
{"title":"DELAYED DIAGNOSIS OF 22Q11.2 DELETION SYNDROME IN A CHILD WITH SYMPTOMATIC HYPOCALCEMIA: CASE REPORT","authors":"C. Rocha, Maisa Sohn, F. Moreschi, Daniel Almeida do Valle, Mara Santos, Vitor Palazzo","doi":"10.25060/residpediatr-2023-623","DOIUrl":"https://doi.org/10.25060/residpediatr-2023-623","url":null,"abstract":"22q11.2 Deletion Syndrome is the commonest microdeletion syndrome in humans and has a wide spectrum of clinical manifestations, such as craniofacial dysmorphism, airway malformations, heart disease, renal malformations, hypoparathyroidism, neurological and behavioral disorders, immunodeficiencies Residência Pediátrica; 2023: Ahead of Print DOI: 10.25060/residpediatr-2023-623 Nota aos leitores: pode haver informações pendentes, por se tratar de um artigo em “visualização pré-publicação”. and anomalies of the thymus. The broad phenotype spectrum makes the diagnosis more challenging, and an early identification allows not only the evaluation of comorbidities and interventions, but also adequate genetic counseling. Hypoparathyroidism manifested by symptomatic hypocalcemia is one of the clinical presentations of 22q11.2 Deletion Syndrome. This clinical case shows the diagnosis of 22q11.2 Deletion Syndrome in an 11-year-old child with symptomatic hypocalcemia and emphasizes the possibility of a late diagnosis of 22q11.2 Deletion Syndrome.","PeriodicalId":338092,"journal":{"name":"Residência Pediátrica","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125863806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.25060/residpediatr-2023.v13n1-819
G. Carlesso, Gabriel Azevedo, Bárbara Ton, T. Vieira, M. Oliveira, G. Pinasco
{"title":"Dyslipidemia in childhood: A literature review","authors":"G. Carlesso, Gabriel Azevedo, Bárbara Ton, T. Vieira, M. Oliveira, G. Pinasco","doi":"10.25060/residpediatr-2023.v13n1-819","DOIUrl":"https://doi.org/10.25060/residpediatr-2023.v13n1-819","url":null,"abstract":"","PeriodicalId":338092,"journal":{"name":"Residência Pediátrica","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123419150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.25060/residpediatr-2023.v13n2-540
Layla Silveira, Williane Fernandes, Allyne Monteiro, L. Valle, A. Soares, D. Barbosa, Deborah Rodrigues, I. Lima, Larisse Leal, Luiza Horst Neto, Pollyanna Resende
BACKGROUND: Perinatal Tuberculosis (TB) is a rare disease, transmitted during pregnancy or postnatal. Its clinical presentation is similar to congenital infections and neonatal sepsis, thus, remains underestimated and underdiagnosed. CASE PRESENTATION: A 34 week female child, born vaginally, with no prenatal intercurrences. Was admitted in neonatal Intensive Care Unit (ICU) in need of ventilatory support and antibiotic therapy for presumed neonatal sepsis. During the case evolution, a treatment for suspected fungical sepsis was initiated, and after 48h, the newborn showed bilateral otitis media and otomastoiditis. Meanwhile, the newborns mother was hospitalized with miliar TB. Thereby, the newborn was treated for latent TB with Rifampicin, and a lymph node exeresis was made for tuberculosis quick testing (TRM-Ultra) and culture. Since the TRM-Ultra was positive, the treatment was switched to Rifampicin, Isoniazid and Pyrazinamide in order to treat presumed Perinatal TB. The newborn has evolved well and the culture demonstrated Mycobacterium tuberculosis. DISCUSSION: The congenital form of Perinatal TB is transmitted intrauterus by mothers with severe and/or genital TB, while postnatal occurs due to newborns contact with bacilliferous individual after birth. The diagnosis, as the differentiation between the two forms, are hampered by non-specific clinical manifestations. CONCLUSION: This case demonstrates the importance of considering perinatal TB in unspecified symptomatology cases that are not responsive to conventional antibiotic therapy. Despite the uncertainty regarding the time of infection, besides late diagnosis and treatment, the patient obtained a satisfactory clinical outcome.
{"title":"Perinatal tuberculosis: a diagnosis to be considered","authors":"Layla Silveira, Williane Fernandes, Allyne Monteiro, L. Valle, A. Soares, D. Barbosa, Deborah Rodrigues, I. Lima, Larisse Leal, Luiza Horst Neto, Pollyanna Resende","doi":"10.25060/residpediatr-2023.v13n2-540","DOIUrl":"https://doi.org/10.25060/residpediatr-2023.v13n2-540","url":null,"abstract":"BACKGROUND: Perinatal Tuberculosis (TB) is a rare disease, transmitted during pregnancy or postnatal. Its clinical presentation is similar to congenital infections and neonatal sepsis, thus, remains underestimated and underdiagnosed. CASE PRESENTATION: A 34 week female child, born vaginally, with no prenatal intercurrences. Was admitted in neonatal Intensive Care Unit (ICU) in need of ventilatory support and antibiotic therapy for presumed neonatal sepsis. During the case evolution, a treatment for suspected fungical sepsis was initiated, and after 48h, the newborn showed bilateral otitis media and otomastoiditis. Meanwhile, the newborns mother was hospitalized with miliar TB. Thereby, the newborn was treated for latent TB with Rifampicin, and a lymph node exeresis was made for tuberculosis quick testing (TRM-Ultra) and culture. Since the TRM-Ultra was positive, the treatment was switched to Rifampicin, Isoniazid and Pyrazinamide in order to treat presumed Perinatal TB. The newborn has evolved well and the culture demonstrated Mycobacterium tuberculosis. DISCUSSION: The congenital form of Perinatal TB is transmitted intrauterus by mothers with severe and/or genital TB, while postnatal occurs due to newborns contact with bacilliferous individual after birth. The diagnosis, as the differentiation between the two forms, are hampered by non-specific clinical manifestations. CONCLUSION: This case demonstrates the importance of considering perinatal TB in unspecified symptomatology cases that are not responsive to conventional antibiotic therapy. Despite the uncertainty regarding the time of infection, besides late diagnosis and treatment, the patient obtained a satisfactory clinical outcome.","PeriodicalId":338092,"journal":{"name":"Residência Pediátrica","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126615902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.25060/residpediatr-2021.v11n3-245
Sara Jorge, Mariana Colodetti, L. Passamani, Caio Passamani, Adriana Dias, Consuêlo Junqueira, Jovanna Anechini, Andrea Pereira
Umbilical vein catheterization (UVC) in newborns (NB) is frequently used as a vascular access. Due to its invasive characteristics, complications may occur, such as cardiac tamponade. The aim of this article is to report a case of pericardial effusion with “swimming heart” resulting from a newborn UVC and to propose preventive approaches to avoid UVC-related complications.
{"title":"Case report: pericardial effusion with \"swimming heart\" after umbilical venous catheterization","authors":"Sara Jorge, Mariana Colodetti, L. Passamani, Caio Passamani, Adriana Dias, Consuêlo Junqueira, Jovanna Anechini, Andrea Pereira","doi":"10.25060/residpediatr-2021.v11n3-245","DOIUrl":"https://doi.org/10.25060/residpediatr-2021.v11n3-245","url":null,"abstract":"Umbilical vein catheterization (UVC) in newborns (NB) is frequently used as a vascular access. Due to its invasive characteristics, complications may occur, such as cardiac tamponade. The aim of this article is to report a case of pericardial effusion with “swimming heart” resulting from a newborn UVC and to propose preventive approaches to avoid UVC-related complications.","PeriodicalId":338092,"journal":{"name":"Residência Pediátrica","volume":"2020 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115585120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.25060/residpediatr-2018.v8s1-14
Camila dos Santos El Halal, M. L. Nunes
OBJECTIVE: the aim of this article is to describe the main sleep disturbances in the paediatric age group, as well as the diagnostic criteria and management for the paediatrician. METHODS: a non-systematic review of the current literature was made, based on the most recent international classification. RESULTS: sleep disturbances are common in the paediatric age group, and can lead to a series of behavioural, social, and cognitive diurnal consequences. A sleep-directed interview is essential for suspicion and, frequently, sufficient for the diagnosis. The management is dependent on the diagnosis, as well as the severity of symptoms. CONCLUSION: the paediatrician plays an important role in the detection of sleep disturbances. Awareness of such conditions is essential for diagnosis and early management.
{"title":"Sleep disorders in childhood","authors":"Camila dos Santos El Halal, M. L. Nunes","doi":"10.25060/residpediatr-2018.v8s1-14","DOIUrl":"https://doi.org/10.25060/residpediatr-2018.v8s1-14","url":null,"abstract":"OBJECTIVE: the aim of this article is to describe the main sleep disturbances in the paediatric age group, as well as the diagnostic criteria and management for the paediatrician. METHODS: a non-systematic review of the current literature was made, based on the most recent international classification. RESULTS: sleep disturbances are common in the paediatric age group, and can lead to a series of behavioural, social, and cognitive diurnal consequences. A sleep-directed interview is essential for suspicion and, frequently, sufficient for the diagnosis. The management is dependent on the diagnosis, as well as the severity of symptoms. CONCLUSION: the paediatrician plays an important role in the detection of sleep disturbances. Awareness of such conditions is essential for diagnosis and early management.","PeriodicalId":338092,"journal":{"name":"Residência Pediátrica","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122289309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.25060/residpediatr-2022.v12n3-519
A. Hachem, J. Lyra, Eric W Scarpa, M. Bentlin
OBJECTIVE: To update the topic through a literature review. METHODS: A search was performed on the MEDLINE, PubMed, SciELO, LILACS and Cochrane platforms, using keywords on the topic and, after selecting the main articles, they were analyzed. CONCLUSION: Necrotizing enterocolitis (NEC) is an inflammation that affects the gastrointestinal tract (GIT) of newborns. The modified Bell stagind criteria classifies it, according to clinical and radiographic findings, into suspicion, confirmed or advanced. Pathogenesis is not completely understood. In term babies it occurs due to poor mesenteric perfusion. The classic form occurs in preterm infants, with multifactorial pathophysiology that includes: immaturity of the GIT, genetic predisposition, changes in the intestinal microbiota, pathogenic bacteria, characteristics of enteral nutrition and hypoxic-ischemic intestinal injury. All of these factors activate an intense inflammatory cascade, which can lead to intestinal necrosis. Risk factors are prematurity, low birth weight, sepsis, persistence of the ductus arteriosus, anemia and/or transfusion, among others. In addition to gastrointestinal symptoms (abdominal distention and pain, gastric residuals, vomiting and rectal bleeding), it has nonspecific symptoms such as temperature instability, apneas, hypoglycemia or even shock. On radiographic examination, bowel distention, pneumatosis, portal vein gas, pneumoperitoneum, intraperitoneal fluid or persistent dilated loops are found. The therapeutic approach includes fasting, broad-spectrum antibiotics, hemodynamic monitoring. Surgery is indicated when clinical worsening, perforation or suspicion of necrosis occurs. Among the preventive measures are: infection control, breastfeeding, protocols for the initiation and progression of enteral nutrition and administration of probiotics.
{"title":"Necrotizing enterocolitis: a literature review","authors":"A. Hachem, J. Lyra, Eric W Scarpa, M. Bentlin","doi":"10.25060/residpediatr-2022.v12n3-519","DOIUrl":"https://doi.org/10.25060/residpediatr-2022.v12n3-519","url":null,"abstract":"OBJECTIVE: To update the topic through a literature review. METHODS: A search was performed on the MEDLINE, PubMed, SciELO, LILACS and Cochrane platforms, using keywords on the topic and, after selecting the main articles, they were analyzed. CONCLUSION: Necrotizing enterocolitis (NEC) is an inflammation that affects the gastrointestinal tract (GIT) of newborns. The modified Bell stagind criteria classifies it, according to clinical and radiographic findings, into suspicion, confirmed or advanced. Pathogenesis is not completely understood. In term babies it occurs due to poor mesenteric perfusion. The classic form occurs in preterm infants, with multifactorial pathophysiology that includes: immaturity of the GIT, genetic predisposition, changes in the intestinal microbiota, pathogenic bacteria, characteristics of enteral nutrition and hypoxic-ischemic intestinal injury. All of these factors activate an intense inflammatory cascade, which can lead to intestinal necrosis. Risk factors are prematurity, low birth weight, sepsis, persistence of the ductus arteriosus, anemia and/or transfusion, among others. In addition to gastrointestinal symptoms (abdominal distention and pain, gastric residuals, vomiting and rectal bleeding), it has nonspecific symptoms such as temperature instability, apneas, hypoglycemia or even shock. On radiographic examination, bowel distention, pneumatosis, portal vein gas, pneumoperitoneum, intraperitoneal fluid or persistent dilated loops are found. The therapeutic approach includes fasting, broad-spectrum antibiotics, hemodynamic monitoring. Surgery is indicated when clinical worsening, perforation or suspicion of necrosis occurs. Among the preventive measures are: infection control, breastfeeding, protocols for the initiation and progression of enteral nutrition and administration of probiotics.","PeriodicalId":338092,"journal":{"name":"Residência Pediátrica","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122164178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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