What is Abdominal Distension?
Abdominal distension refers to the swelling or enlargement of the abdomen, which can occur due to an accumulation of gas, fluid, or other contents. In neonates, it can be a sign of various underlying conditions and requires prompt evaluation and management.
Visible enlargement of the abdomen
Poor feeding or refusal to feed
Vomiting, which may be bilious (greenish) in severe cases
Lethargy or irritability
Changes in stool patterns, such as absence of stools or bloody stools
Respiratory distress due to pressure on the diaphragm
Physical Examination: Inspection, palpation, and auscultation of the abdomen.
Abdominal X-ray: To identify air patterns, distended loops of bowel, or free air indicating perforation.
Ultrasound: Useful for evaluating fluid collections and assessing blood flow in cases of suspected volvulus.
Blood Tests: To check for signs of infection, electrolyte imbalances, and organ function.
Contrast Studies: Such as a barium enema or upper GI series to assess for obstructions or malformations.
Medical Management: Includes the use of antibiotics for infections like NEC, and supportive care such as IV fluids and nasogastric decompression.
Surgical Intervention: Required for conditions like intestinal atresia, malrotation with volvulus, or complicated cases of NEC.
Nutritional Support: Parenteral nutrition may be necessary until the infant can tolerate enteral feeding.
What is the Prognosis?
The prognosis varies widely depending on the underlying condition and the timeliness of treatment. Early diagnosis and intervention are crucial for better outcomes. For instance, with prompt treatment, many infants with NEC or intestinal atresia can recover well, while delayed treatment can lead to severe complications or even mortality.
When Should You Seek Medical Attention?
Immediate medical evaluation is essential if a neonate shows signs of abdominal distension, particularly if accompanied by vomiting, poor feeding, lethargy, or changes in stool patterns. Early intervention can significantly improve outcomes and prevent complications.
