Necrotizing Enterocolitis Case Details

F/B/O Reshma pawar, 22 yrs old, delivered , female baby of wt 1600gm, 35 wks, (preterm, LSCS, PIH) at chinmay hospital. As baby was preterm, was weak, unable to take feeds, and on oxygen support. Baby was admitted in NICU on 12/ 3/ 04 . with following presentation , baby very weak, excessive crying , yellowish discolouration of the skin, she was on treatment : IV fluids, antibiotics, sugar water 2cc 2hrly. 3-4 days later baby refused feeds. Vomitus bloody stained (brownish red in colour) shows poor assimilation and digestion.

5 days later (16 march) physiological jaundice increased her billirubin level 16 mg % so decided and gave FFP (fresh frozen plasma) accordingly wt. simultaneous phototherapy given along with conservative treatment, her billirubin level reduced gradually. Showed improvement in general condition by accepting feeds with very minimal aspiration. 2 days later suddenly present with malena, and large amount bloody aspiration ( colour blood dark brown) showing focus of old injury ( stomach, intestine ) ecchymotic patches seen on flexor aspects ( cubital fossa, ear, pinna popliteal fossa, groins, armpits) general condition deranged. Still continued with treatment. No improvement. Landed in complication.

Condition explained to relatives, decided to discontinue treatment, as relatives were not afford the cost of treatment.

They gave up the case at that time I was student doing my P.G. my inner conscience was not ready to give baby on death bed, so I decided to start Homoeopathic treatment.

Without asking to my teacher, After seeing baby her gestures, body language, I came to conclusion that she had severe injuries at physical level, mental level, in spite of all injuries she was quite well no cry lying bearing all pains, so I decided to give her Arnica 30 frequently as per my knowledge.

I started with ARNICA 30.

OBSERVATIONS:

2 drops with feed (sugar water) 2 hrly for first 2 days. General condition improved , baby accepted feeds . aspiration reduced, urine out put adequate, still malena present, ecchymotic patches +++.

Frequency reduced, continued with same potency (2 drops with feeds 4 hrly), for 3 days. Colour of aspirate changed from dark brown to light with reduced quantity, ecchymotic patches reduced in size, started with lactogen 2hrly inspite of sugar water., malena present.

Frequency still reduced same potency (2 drops with feed 8 hrly) for 4 days. Aspiration very minimal with clear aspirate, Ecchymotic patches reduced in size as compared to before, stools are light brown in colour, feeds tolerated well, hunger cry seen showing increased appetite, baby active.

Frequency still reduced same potency (2 drops with feed 12 hrly) for 3 days. No aspiration, stools regular and normal, feeds tolerated well, E.patches cleared, baby active, G.C. Good.

After seeing those symptoms I came to Totality:

1. 1. Head hot to touch with coldness of the limbs and abdomen.


2. 2. A/F, Injury --- physical level, mucosal layer level, mechanical level.


3. 3. Ecchymotic patches on flexor aspect, cubital fossa, popliteal fossa, groins armpits, Ear pinna.


4. 4. Stools are bloody dark and offensive.


5. 5. Vomiting of blood, brownish red in colour.


6. 6. Distension of abdomen with tenderness.

Potency selection: gross pathological changes, baby was so weak and susceptibility low. At that time I have only 30 and 200 potencies so I selected 30 with frequent repetition.

DIAGNOSIS: NECROTISING ENTEROCOLITIS.