Umbilical Catheter Extravasation Mimicking Necrotizing Enterocolitis in a Preterm Neonate: A Diagnostic Challenge.

Autor:	Armağan C; Dokuz Eylul University Faculty of Medicine, Neonatology, Izmir, Turkey., Çapıtlı T; Dokuz Eylul University Faculty of Medicine, Pediatrics, Izmir, Turkey., Dilmen G; Dokuz Eylul University Faculty of Medicine, Pediatrics, Izmir, Turkey., Kefeli SÇ; Dokuz Eylul University Faculty of Medicine, Pediatric Surgery, Izmir, Turkey., Ulusoy O; Dokuz Eylul University Faculty of Medicine, Pediatric Surgery, Izmir, Turkey., Erdoğan F; Dokuz Eylul University Faculty of Medicine, Neonatology, Izmir, Turkey., Duman N; Dokuz Eylul University Faculty of Medicine, Neonatology, Izmir, Turkey., Özkan H; Dokuz Eylul University Faculty of Medicine, Neonatology, Izmir, Turkey.
Jazyk:	angličtina
Zdroj:	Zeitschrift fur Geburtshilfe und Neonatologie [Z Geburtshilfe Neonatol] 2024 Oct; Vol. 228 (5), pp. 454-457. Date of Electronic Publication: 2024 May 06.
DOI:	10.1055/a-2295-5110
Abstrakt:	Managing acute abdomen in very low birth weight (VLBW) and premature infants presents a diagnostic challenge, often necessitating a thorough assessment to discern underlying causes. Umbilical venous catheters (UVCs), commonly used in neonatal intensive care, are essential but not without risks. A 29-week premature male infant, born to a 23-year-old mother, was referred to our clinic on the 16 th day of life with a suspected diagnosis of necrotizing enterocolitis (NEC). The infant had spent the first day intubated and received non-invasive respiratory support for 15 days. A 5 French UVC was inserted at the 2 nd hour of life, and by the 3 rd day of life, the infant transitioned to minimal enteral feeding. Between the 12 th and 16 th days of life, the infant initially diagnosed with NEC due to symptoms such as decreased stool passage and abdominal distension. The patient had been on a continuous course of antibiotic treatment throughout the entirety of his life, commencing on the very first day due to suspected early neonatal sepsis, followed by nosocomial sepsis during the hospitalization, and persisting with antibiotic therapy for suspected NEC. The case took a unique turn upon further evaluation after being referred to our unit. Despite a preliminary NEC diagnosis, further evaluation revealed umbilical catheter complications, leading to total parenteral nutrition extravasation. Removal of the catheter, drainage, and antibiotic adjustment resulted in improved clinical outcomes. In neonatal care, cautious management is vital when dealing with infants exhibiting abdominal symptoms. A nuanced approach, including differential diagnosis and careful antibiotic use, is essential. Competing Interests: The authors declare that they have no conflict of interest. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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