Necrotizing enterocolitis Quiz: Ace Your Exams
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A 2-week-old baby girl born at 28 weeks via spontaneous vaginal delivery is being evaluated in the neonatal intensive care unit (NICU) for low blood pressure. The pregnancy was uncomplicated, and the mother took prenatal vitamins throughout. At birth, the baby weighed 1.7 kg and had been progressing well in the NICU, tolerating enteral feeds. Today, she appears lethargic and has had blood in the stool. Temperature is 100.3°F (38 °C), heart rate is 155/min, respiratory rate is 35/min, and blood pressure is 60/32 mmHg. The patient is sleeping but can be aroused and is moving all four extremities. Exam is notable for decreased bowel sounds, diffuse abdominal distention, and generalized tenderness to palpation without rebound or guarding. Abdominal radiographs are obtained which reveal a small area of pneumatosis intestinalis without evidence of pneumoperitoneum. Given the most likely diagnosis, which of the following is the most appropriate next step in management?
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