Short bowel syndrome

You are the gastroenterology registrar and have been referred a neonate from the NICU. He was born at 30 weeks gestation but unfortunately developed fulminant sepsis secondary to necrotising enterocolitis. He underwent a laparotomy and had 15 cm of dead gut removed. He is now being referred to you for long term management of short…

Listen to the nurses

A 9-year old male was brought to the ED after fainting in school. Upon awakening in the morning, he vomited twice, but he was sent to school. At school, he vomited three more times and continued to feel ill and weak. He fainted briefly, which prompted the school nurse to call his mother who brought…

Nutrition

Facts: 1. Nutritional support for children in PICU is important to prevent deficiency and remain in a positive or neutral neutrogen balance 2. Overfeeding is associated with adverse effects 3. There is no clear evidence supporting PN over TPN 4. If the bowel works, use it ! 5. Always slowly introduce lipids ! 5. Cautiously…

Target sign

Target Sign

The target sign consists of two approximately concentric circles of fat density to the right of the spine, due to layers of peritoneal fat surrounding and within the intussusceptum alternating with layers of mucosa and muscle. This sign resembles a very faint target, or bull’s eye, or doughnut appearance. This radiograph shows a classic target…