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Gastric pneumatosis, etiology uncertain

USU Teaching File MUTF - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Gastric pneumatosis, etiology uncertain

History: 24+6 week infant at day of life 8 for a corrected age of 26 weeks. Pt premature secondary to incompetent cervix with failure of cerclage. Pt with a history of umbilical artery and umbilical venous lines after birth, history of hyperkalemia, leukemoid reaction, and respiratory distress. Pt with birth trauma and bruising to left lower extremity. Pt with ng tube, UVC, and ET tube. Pt on day 3 of enteral feeds with new residual after morning ng feed. The residual was dark red in color with the consistency of digested formula. Pt was made NPO after residual. Pt without other signs of infection or changes in vent settings.

Findings: Premature infant with UVC, ET tube, and NG/OG tube.Area of pneumatosis in the stomach wall. Dilated loops of bowel in RLQ. Otherwise abdomen normal.

Ddx: 1. Necrotizing enterocolitis 2. Gastric outlet obstruction a. Duodenal atresia b. Malrotation with volvulus 3. Iatrogenic gastric mucosal injury 4. Emphysematous gastroenteritis - gas-forming organism

Exam: General: Premature infant in isolette VS: 57/38 HR 148 RR 64 SpO2 90 HEENT: AF soft, flat Lungs: CTAB; Good chest wall movement CV: RR; No murmur Abd: Hypoactive bowel sounds; Moderate distention; No palpable loops; No mass Skin: Improved bruising of left lower extremity Ext: Symmetric with FROM Neuro: Good tone Lytes: Na 137 K 4.7 Cl 100 CO2 27 BUN 23 Cr 0.8 Glu 93 Ca 9.4 Mg 2.5H/H: Hgb 9.5 HCT 27.3 WBC 19.4 Plt 68 Blood Cx: Negative CSF and UA: attempts were made to acquire samples, but unsuccessful Stool: Guaiac positive

No MeSH data available.


Premature infant with UVC, ET tube, and NG/OG tube.  Area of pneumatosis in the stomach wall.  Dilated loops of bowel in RLQ.  Otherwise abdomen normal.
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MPX1068_synpic15253: Premature infant with UVC, ET tube, and NG/OG tube. Area of pneumatosis in the stomach wall. Dilated loops of bowel in RLQ. Otherwise abdomen normal.


Gastric pneumatosis, etiology uncertain

USU Teaching File MUTF - MedPix

Premature infant with UVC, ET tube, and NG/OG tube.  Area of pneumatosis in the stomach wall.  Dilated loops of bowel in RLQ.  Otherwise abdomen normal.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1068&req=5

MPX1068_synpic15253: Premature infant with UVC, ET tube, and NG/OG tube. Area of pneumatosis in the stomach wall. Dilated loops of bowel in RLQ. Otherwise abdomen normal.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Gastric pneumatosis, etiology uncertain

History: 24+6 week infant at day of life 8 for a corrected age of 26 weeks. Pt premature secondary to incompetent cervix with failure of cerclage. Pt with a history of umbilical artery and umbilical venous lines after birth, history of hyperkalemia, leukemoid reaction, and respiratory distress. Pt with birth trauma and bruising to left lower extremity. Pt with ng tube, UVC, and ET tube. Pt on day 3 of enteral feeds with new residual after morning ng feed. The residual was dark red in color with the consistency of digested formula. Pt was made NPO after residual. Pt without other signs of infection or changes in vent settings.

Findings: Premature infant with UVC, ET tube, and NG/OG tube.Area of pneumatosis in the stomach wall. Dilated loops of bowel in RLQ. Otherwise abdomen normal.

Ddx: 1. Necrotizing enterocolitis 2. Gastric outlet obstruction a. Duodenal atresia b. Malrotation with volvulus 3. Iatrogenic gastric mucosal injury 4. Emphysematous gastroenteritis - gas-forming organism

Exam: General: Premature infant in isolette VS: 57/38 HR 148 RR 64 SpO2 90 HEENT: AF soft, flat Lungs: CTAB; Good chest wall movement CV: RR; No murmur Abd: Hypoactive bowel sounds; Moderate distention; No palpable loops; No mass Skin: Improved bruising of left lower extremity Ext: Symmetric with FROM Neuro: Good tone Lytes: Na 137 K 4.7 Cl 100 CO2 27 BUN 23 Cr 0.8 Glu 93 Ca 9.4 Mg 2.5H/H: Hgb 9.5 HCT 27.3 WBC 19.4 Plt 68 Blood Cx: Negative CSF and UA: attempts were made to acquire samples, but unsuccessful Stool: Guaiac positive

No MeSH data available.