Portal venous gas by ultrasound in advance of impending necrotizing enterocolitis of a very low birth weight infant

Abstract

Necrotizing enterocolitis (NEC) is a serious complication of premature infants, portal venous gas (PVG) under X‐ray, and ultrasound is a typical manifestation of this disease. We report a case of a very low birth weight (VLBW) infant with PVG unexpectedly detected by ultrasound before the onset of NEC. After positive ultrasound result, clinical manifestations, X‐ray, and lab tests confirmed the diagnosis of NEC. This is the first report of a similar case, demonstrating the value of ultrasonography in prediction or early diagnosis of NEC, which may change our understanding of the disease and the timing of examination.

The Role Sonographic Imaging Features in the Prediction of Necrotizing Enterocolitis Outcomes in Neonatal Patients

“…The portal venous gas(PVG) observedby X-ray or sonographic imagingis also considered as a typicaldiagnostic feature of confirmed necrotizing enterocolitis. Some data reported that PVG can be a predictive diagnosis for the onset of NEC, which was first identified by Yue et al, who discovered the occurrence of portal gas before the onset of NEC (12) .…”

Predictive Indicators for Necrotizing Enterocolitis With the Presence of Portal Venous Gas and Outcomes of Surgical Interventions

“…Portal venous gas (PVG) was an important clinical sign in stage II or III NEC in preterm neonates. The detection of PVG on abdominal ultrasound (AUS) (as opposed to on X-ray examination) was proven to be as early sign of impending NEC in VLBW neonates ( 7 ), and sonographic findings of PVG (OR = 3.9) were significantly associated with surgery and/or death ( 8 ). Moreover, PVG was detected by the AUS with high specificity (86–100%) and proper sensitivity (3–45%) in the diagnostic value of NEC in preterm neonates ( 9 ).…”