We want to know when the baby has surgical neck, when we need to operate. An ultrasound scan can tell you a little bit more about. The bowel, bowel wall thickening, thinning, perfusion, peristalsis, what's inside the abdomen, what happens at the level of the peritoneum and the liver.
I think you need to be prepared to have some negative laparotomies. There will be some in which unfortunately, you think it's perforated, actually it's not, but definitely if there's like turbid-free fluid, there's something going on there.
Maybe it's not that popular, but the ultrasound really gives you a lot of more clues that the abdominal X-ray. Abdominal X-rays are highly specific, but very low sensitivity.
In stable babies where approximately 10 cm of necrotic segment is removed for source control, they do not necessarily do poorly afterwards and there is long-term benefit
Update Course Rewind 2025: Updates in NEC Management
▶Ep 74 · 0:54
quoteWe still don't know what causes it for our surgeons, how do we really diagnose it? What's the right time to operate? Are there some babies that are too sick to be operated on? And then when we do an operation, which one, when do we restart feeds for these babies, which antibiotics, and for how long do we refeed the mucus fstu if you have one?↗
▶Ep 74 · 1:51
quoteMaybe it's not that popular, but the ultrasound really gives you a lot of more clues that the abdominal X-ray. Abdominal X-rays are highly specific, but very low sensitivity.↗
▶Ep 74 · 1:56
clinicalAbdominal X-rays for NEC have high specificity but very low sensitivity, with studies showing sensitivity between 13 and 25%↗
▶Ep 74 · 2:26
quoteWe want to know when the baby has surgical neck, when we need to operate. An ultrasound scan can tell you a little bit more about. The bowel, bowel wall thickening, thinning, perfusion, peristalsis, what's inside the abdomen, what happens at the level of the peritoneum and the liver.↗
▶Ep 74 · 2:30
clinicalUltrasound can assess bowel wall thickening, thinning, perfusion, peristalsis, intra-abdominal contents, peritoneum, and liver↗
▶Ep 74 · 2:59
clinicalHigh-risk ultrasound findings for bowel perforation include pneumoperitoneum, focal fluid collections, and complex fluid↗
▶Ep 74 · 3:07
clinicalIntermediate-risk ultrasound findings include increased bowel wall echogenicity, absent perfusion, portal venous gas, and bowel thinning and thickening↗
▶Ep 74 · 3:56
opinionThe majority of surgeons would perform laparotomy rather than drain placement for perforated NEC↗
▶Ep 74 · 4:47
clinicalIn stable babies where approximately 10 cm of necrotic segment is removed for source control, they do not necessarily do poorly afterwards and there is long-term benefit↗
▶Ep 74 · 6:34
quoteYou're in the middle of the operation, and this means that the baby is hemodynamically stable, and then you would then scrub and go to the computer and go for randomization. Now you can tell you that the fellows, when it was like an anastomosis, were like, oh my God, now we're doing this to 500 grammers, but they were the strongest believers when they saw how these babies progressed afterwards.↗
▶Ep 74 · 9:45
opinionSurgeons need to be prepared to have some negative laparotomies when clinical suspicion is high despite equivocal imaging↗
▶Ep 74 · 9:45
quoteI think you need to be prepared to have some negative laparotomies. There will be some in which unfortunately, you think it's perforated, actually it's not, but definitely if there's like turbid-free fluid, there's something going on there.↗
Augusto's statements about Intestinal Rehab12 statements
Update Course Rewind 2025: Updates in NEC Management
▶Ep 106 · 0:54
quoteWe still don't know what causes it for our surgeons, how do we really diagnose it? What's the right time to operate? Are there some babies that are too sick to be operated on? And then when we do an operation, which one, when do we restart feeds for these babies, which antibiotics, and for how long do we refeed the mucus fstu if you have one?↗
▶Ep 106 · 1:51
quoteMaybe it's not that popular, but the ultrasound really gives you a lot of more clues that the abdominal X-ray. Abdominal X-rays are highly specific, but very low sensitivity.↗
▶Ep 106 · 1:56
clinicalAbdominal X-rays for NEC have high specificity but very low sensitivity, with studies showing sensitivity between 13 and 25%↗
▶Ep 106 · 2:26
quoteWe want to know when the baby has surgical neck, when we need to operate. An ultrasound scan can tell you a little bit more about. The bowel, bowel wall thickening, thinning, perfusion, peristalsis, what's inside the abdomen, what happens at the level of the peritoneum and the liver.↗
▶Ep 106 · 2:30
clinicalUltrasound can assess bowel wall thickening, thinning, perfusion, peristalsis, intra-abdominal contents, peritoneum, and liver↗
▶Ep 106 · 2:59
clinicalHigh-risk ultrasound findings for bowel perforation include pneumoperitoneum, focal fluid collections, and complex fluid↗
▶Ep 106 · 3:07
clinicalIntermediate-risk ultrasound findings include increased bowel wall echogenicity, absent perfusion, portal venous gas, and bowel thinning and thickening↗
▶Ep 106 · 3:56
opinionThe majority of surgeons would perform laparotomy rather than drain placement for perforated NEC↗
▶Ep 106 · 4:47
clinicalIn stable babies where approximately 10 cm of necrotic segment is removed for source control, they do not necessarily do poorly afterwards and there is long-term benefit↗
▶Ep 106 · 6:34
quoteYou're in the middle of the operation, and this means that the baby is hemodynamically stable, and then you would then scrub and go to the computer and go for randomization. Now you can tell you that the fellows, when it was like an anastomosis, were like, oh my God, now we're doing this to 500 grammers, but they were the strongest believers when they saw how these babies progressed afterwards.↗
▶Ep 106 · 9:45
opinionSurgeons need to be prepared to have some negative laparotomies when clinical suspicion is high despite equivocal imaging↗
▶Ep 106 · 9:45
quoteI think you need to be prepared to have some negative laparotomies. There will be some in which unfortunately, you think it's perforated, actually it's not, but definitely if there's like turbid-free fluid, there's something going on there.↗
Augusto's statements about Necrotizing Enterocolitis12 statements
Update Course Rewind 2025: Updates in NEC Management
▶Ep 31 · 0:54
quoteWe still don't know what causes it for our surgeons, how do we really diagnose it? What's the right time to operate? Are there some babies that are too sick to be operated on? And then when we do an operation, which one, when do we restart feeds for these babies, which antibiotics, and for how long do we refeed the mucus fstu if you have one?↗
▶Ep 31 · 1:51
quoteMaybe it's not that popular, but the ultrasound really gives you a lot of more clues that the abdominal X-ray. Abdominal X-rays are highly specific, but very low sensitivity.↗
▶Ep 31 · 1:56
clinicalAbdominal X-rays for NEC have high specificity but very low sensitivity, with studies showing sensitivity between 13 and 25%↗
▶Ep 31 · 2:26
quoteWe want to know when the baby has surgical neck, when we need to operate. An ultrasound scan can tell you a little bit more about. The bowel, bowel wall thickening, thinning, perfusion, peristalsis, what's inside the abdomen, what happens at the level of the peritoneum and the liver.↗
▶Ep 31 · 2:30
clinicalUltrasound can assess bowel wall thickening, thinning, perfusion, peristalsis, intra-abdominal contents, peritoneum, and liver↗
▶Ep 31 · 2:59
clinicalHigh-risk ultrasound findings for bowel perforation include pneumoperitoneum, focal fluid collections, and complex fluid↗
▶Ep 31 · 3:07
clinicalIntermediate-risk ultrasound findings include increased bowel wall echogenicity, absent perfusion, portal venous gas, and bowel thinning and thickening↗
▶Ep 31 · 3:56
opinionThe majority of surgeons would perform laparotomy rather than drain placement for perforated NEC↗
▶Ep 31 · 4:47
clinicalIn stable babies where approximately 10 cm of necrotic segment is removed for source control, they do not necessarily do poorly afterwards and there is long-term benefit↗
▶Ep 31 · 6:34
quoteYou're in the middle of the operation, and this means that the baby is hemodynamically stable, and then you would then scrub and go to the computer and go for randomization. Now you can tell you that the fellows, when it was like an anastomosis, were like, oh my God, now we're doing this to 500 grammers, but they were the strongest believers when they saw how these babies progressed afterwards.↗
▶Ep 31 · 9:45
opinionSurgeons need to be prepared to have some negative laparotomies when clinical suspicion is high despite equivocal imaging↗
▶Ep 31 · 9:45
quoteI think you need to be prepared to have some negative laparotomies. There will be some in which unfortunately, you think it's perforated, actually it's not, but definitely if there's like turbid-free fluid, there's something going on there.↗
Augusto's statements about Necrotizing Enterocolitis12 statements
Update Course Rewind 2025: Updates in NEC Management
▶Ep 12 · 0:54
quoteWe still don't know what causes it for our surgeons, how do we really diagnose it? What's the right time to operate? Are there some babies that are too sick to be operated on? And then when we do an operation, which one, when do we restart feeds for these babies, which antibiotics, and for how long do we refeed the mucus fstu if you have one?↗
▶Ep 12 · 1:51
quoteMaybe it's not that popular, but the ultrasound really gives you a lot of more clues that the abdominal X-ray. Abdominal X-rays are highly specific, but very low sensitivity.↗
▶Ep 12 · 1:56
clinicalAbdominal X-rays for NEC have high specificity but very low sensitivity, with studies showing sensitivity between 13 and 25%↗
▶Ep 12 · 2:26
quoteWe want to know when the baby has surgical neck, when we need to operate. An ultrasound scan can tell you a little bit more about. The bowel, bowel wall thickening, thinning, perfusion, peristalsis, what's inside the abdomen, what happens at the level of the peritoneum and the liver.↗
▶Ep 12 · 2:30
clinicalUltrasound can assess bowel wall thickening, thinning, perfusion, peristalsis, intra-abdominal contents, peritoneum, and liver↗
▶Ep 12 · 2:59
clinicalHigh-risk ultrasound findings for bowel perforation include pneumoperitoneum, focal fluid collections, and complex fluid↗
▶Ep 12 · 3:07
clinicalIntermediate-risk ultrasound findings include increased bowel wall echogenicity, absent perfusion, portal venous gas, and bowel thinning and thickening↗
▶Ep 12 · 3:56
opinionThe majority of surgeons would perform laparotomy rather than drain placement for perforated NEC↗
▶Ep 12 · 4:47
clinicalIn stable babies where approximately 10 cm of necrotic segment is removed for source control, they do not necessarily do poorly afterwards and there is long-term benefit↗
▶Ep 12 · 6:34
quoteYou're in the middle of the operation, and this means that the baby is hemodynamically stable, and then you would then scrub and go to the computer and go for randomization. Now you can tell you that the fellows, when it was like an anastomosis, were like, oh my God, now we're doing this to 500 grammers, but they were the strongest believers when they saw how these babies progressed afterwards.↗
▶Ep 12 · 9:45
quoteI think you need to be prepared to have some negative laparotomies. There will be some in which unfortunately, you think it's perforated, actually it's not, but definitely if there's like turbid-free fluid, there's something going on there.↗
▶Ep 12 · 9:45
opinionSurgeons need to be prepared to have some negative laparotomies when clinical suspicion is high despite equivocal imaging↗
Augusto's statements about Necrotizing Enterocolitis12 statements
Update Course Rewind 2025: Updates in NEC Management
▶Ep 23 · 0:54
quoteWe still don't know what causes it for our surgeons, how do we really diagnose it? What's the right time to operate? Are there some babies that are too sick to be operated on? And then when we do an operation, which one, when do we restart feeds for these babies, which antibiotics, and for how long do we refeed the mucus fstu if you have one?↗
▶Ep 23 · 1:51
quoteMaybe it's not that popular, but the ultrasound really gives you a lot of more clues that the abdominal X-ray. Abdominal X-rays are highly specific, but very low sensitivity.↗
▶Ep 23 · 1:56
clinicalAbdominal X-rays for NEC have high specificity but very low sensitivity, with studies showing sensitivity between 13 and 25%↗
▶Ep 23 · 2:26
quoteWe want to know when the baby has surgical neck, when we need to operate. An ultrasound scan can tell you a little bit more about. The bowel, bowel wall thickening, thinning, perfusion, peristalsis, what's inside the abdomen, what happens at the level of the peritoneum and the liver.↗
▶Ep 23 · 2:30
clinicalUltrasound can assess bowel wall thickening, thinning, perfusion, peristalsis, intra-abdominal contents, peritoneum, and liver↗
▶Ep 23 · 2:59
clinicalHigh-risk ultrasound findings for bowel perforation include pneumoperitoneum, focal fluid collections, and complex fluid↗
▶Ep 23 · 3:07
clinicalIntermediate-risk ultrasound findings include increased bowel wall echogenicity, absent perfusion, portal venous gas, and bowel thinning and thickening↗
▶Ep 23 · 3:56
opinionThe majority of surgeons would perform laparotomy rather than drain placement for perforated NEC↗
▶Ep 23 · 4:47
clinicalIn stable babies where approximately 10 cm of necrotic segment is removed for source control, they do not necessarily do poorly afterwards and there is long-term benefit↗
▶Ep 23 · 6:34
quoteYou're in the middle of the operation, and this means that the baby is hemodynamically stable, and then you would then scrub and go to the computer and go for randomization. Now you can tell you that the fellows, when it was like an anastomosis, were like, oh my God, now we're doing this to 500 grammers, but they were the strongest believers when they saw how these babies progressed afterwards.↗
▶Ep 23 · 9:45
opinionSurgeons need to be prepared to have some negative laparotomies when clinical suspicion is high despite equivocal imaging↗
▶Ep 23 · 9:45
quoteI think you need to be prepared to have some negative laparotomies. There will be some in which unfortunately, you think it's perforated, actually it's not, but definitely if there's like turbid-free fluid, there's something going on there.↗
