Early diagnosis of necrotizing enterocolitis

Siegle, Robert L.; Rabinowitz, Jack G.; Korones, Sheldon B.; Eyal, Fabian

doi:10.2214/ajr.127.4.629

Cited by 16 publications

(9 citation statements)

References 3 publications

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“…It is the commonest sign, being present in over 90% of patients, with the remaining 10% showing only minor or nonspecific disturbances of bowel gas pattern ( Fig 5). Dilatation of bowel is an early sign and may even precede the clinical features of NEC by several hours (40,41). Furthermore, the degree of dilatation usually correlates well with the clinical severity of the disease and the distribution of the dilated loops in serial examinations is related to clinical progression (42) ( Fig 6).…”

Section: Imaging Findings Bowel Gas Patternmentioning

confidence: 99%

Necrotizing Enterocolitis: Review of State-of-the-Art Imaging Findings with Pathologic Correlation

Epelman¹,

Daneman²,

Navarro³

et al. 2007

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Plain abdominal radiography is the current standard imaging modality for evaluation of necrotizing enterocolitis (NEC). Sonography is still not routinely used for diagnosis and follow-up, as it is not widely recognized that it can provide information that is not provided by plain abdominal radiography and that may affect the management of NEC. Like plain abdominal radiography, sonography can depict intramural gas, portal venous gas, and free intraperitoneal gas. However, the major advantages of abdominal sonography over plain abdominal radiography are that it can depict intraabdominal fluid, bowel wall thickness, and bowel wall perfusion. Sonography may depict changes consistent with NEC when the plain abdominal radiographic findings are nonspecific and inconclusive. Thinning of the bowel wall and lack of perfusion at sonography are highly suggestive of nonviable bowel and may be seen before visualization of pneumoperitoneum at plain abdominal radiography. The mortality rate is higher after perforation; thus, earlier detection of severely ischemic or necrotic bowel loops, before perforation occurs, could potentially improve the morbidity and mortality in NEC. The information provided by sonography allows a more complete understanding of the state of the bowel in patients with NEC and may thus make management decisions easier and potentially change outcome.

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Section: Imaging Findings Bowel Gas Patternmentioning

confidence: 99%

Necrotizing Enterocolitis: Review of State-of-the-Art Imaging Findings with Pathologic Correlation

Epelman¹,

Daneman²,

Navarro³

et al. 2007

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“…Plain film findings in NEC include early selective dilatation of small bowel, elongation of bowel loops, disorganized atonic pattern of intestinal gas and loss of bowel wall definition [5,6]. While these findings may be helpful they are nonspecific and may be seen in a number of other conditions.…”

Section: Discussionmentioning

confidence: 99%

Use of the barium enema in the diagnosis of necrotizing enterocolitis

et al. 1988

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Necrotizing enterocolitis (NEC) is associated with considerable morbidity and mortality in infants. The diagnosis relies heavily upon radiographic and clinical features. Failure to accurately diagnose NEC is associated with a risk of complications and death, however overdiagnosis also causes both morbidity and mortality as well as excessive medical costs. This report documents the use of barium enema to evaluate suspected clinical or radiographic NEC in 31 premature infants with ambiguous clinical and radiographic signs. The enema was normal in 26 infants and no treatment for NEC was given. Only one of these infants developed signs of NEC subsequent to the examination. Five infants had radiographic evidence of colitis including small ulcerations, spasm, intramural extravasation of barium and mucosal irregularity. Two of the five positive cases are pathologically documented. The barium enema can represent a significant improvement in the specificity of the diagnosis of NEC. Its greatest value is in the exclusion of NEC in ambiguous cases.

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“…The selection of articles may, however, not be complete. 40 1976 X Daneman 22 1978 X X X X X X Kogutt 41 1979 X Mata 48 1980 X X X Leonard 73 1982 X *Cikrit 74 1985 X Frey 75 1987 X X *Kennedy 76 1987 X Kosloske 56 1988 X X X Brill 77 1990 X Bömelburg 78 1992 X X X Rehan 43 1999 X X X X X X Molik 57 2001 X Tam 31 2002 X X X Faingold 70 2005 X Kim 60 2005 X Sharma 23 2005 X X X Coursey 50 2009 X X X X X X X Dördelman 24 2009 X X Bonhorst 34 2011 X Dilli 61 2011 X X X X Muchantef 53 2013 X X X X X X Silva 72 2013 X X X X Muller 79 2014 X * Abstracts only accessed US has been suggested to be used for: detection of PI, PVG, and intra-abdominal fluid and evaluation of bowel peristalsis, thickness, and perfusion of the bowel wall in neonates with mild symptoms and nonspecific plain film findings;…”

Section: Pathophysiologymentioning

confidence: 99%

Necrotising Enterocolitis - epidemiology and imaging

Ahle¹

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Early diagnosis of necrotizing enterocolitis

Cited by 16 publications

References 3 publications

Necrotizing Enterocolitis: Review of State-of-the-Art Imaging Findings with Pathologic Correlation

Necrotizing Enterocolitis: Review of State-of-the-Art Imaging Findings with Pathologic Correlation

Use of the barium enema in the diagnosis of necrotizing enterocolitis

Necrotising Enterocolitis - epidemiology and imaging

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