Value of abdominal ultrasound in the diagnosis of neonatal necrotizing enterocolitis and evaluation of disease severity

Abstract:

Objective To investigate the value of abdominal ultrasound in diagnosing neonatal necrotizing enterocolitis(NEC) and its significance in evaluating the disease severity.Methods The clinical data of 84 neonates who were diagnosed with NEC between July 2013 and January 2015 were analyzed retrospectively.According to the modified Bell-NEC staging criteria, these neonates were divided into a suspected NEC group(n=44) and a confirmed NEC group(n=40);according to clinical prognosis, they were divided into a medical treatment and full recovery group(n=58) and a surgery/death group(n=26).The changes in the results of abdominal ultrasound and abdominal X-ray plain film were compared between groups.Results In the confirmed NEC group, abdominal ultrasound showed significantly higher detection rates of portal venous gas and dilatation of the intestine than abdominal X-ray plain film(P<0.05).Compared with the medical treatment and full recovery group, the surgery/death group had significantly higher detection rates of dilatation of intestine, bowel wall thickening, peritoneal effusion and free intraperitoneal air(P<0.05).Dilatation of the intestine and free intraperitoneal air shown by abdominal X-ray plain film were more common in the surgery/death group.Conclusions Abdominal ultrasound is useful for the diagnosis of NEC.Ultrasonic findings can contribute to the prediction of the severity of NEC.