Application of Abdominal Ultrasonography in Surgical Necrotizing Enterocolitis: a Retrospective Study

Overview

Journal Front Microbiol

Specialty Microbiology

Date 2023 Jun 22

PMID 37346747

Authors

Qin Chen

Weiquan Yao

Fengdan Xu

Jinfeng Liao

Jinfeng Li

Minling Mai

Haoqiang Xie

Xiaoguang He

Ning Li

Affiliations

Soon will be listed here.

Abstract

Background: Necrotizing enterocolitis (NEC) is a severe inflammatory bowel disease that may lead to perforation, causing high morbidity and mortality in preterm infants. Abdominal ultrasound (AUS) has been shown to provide benefits in diagnosing and managing NEC in recent years.

Objective: This study focused on the utility of AUS in the diagnosis and evaluation of surgical NEC.

Patients And Methods: In this retrospective study, available data of the patients diagnosed from January 2019 to June 2022 were reviewed. The sensitivity and specificity of AUS in diagnosing a perforation were analyzed. Typical cases for the application of AUS in monitoring and evaluating the progression, complications, and sequela of NEC were described.

Results: There were 69 neonates diagnosed with NEC and examined by AUS, of whom eight patients developed a perforation. AUS was used for diagnosing a perforation in eight patients with key features of pneumoperitoneum and/or complex ascites, allowing us to find four locations of perforation, with a sensitivity and specificity of 100%.

Conclusion: AUS plays an important role in diagnosing and evaluating surgical NEC in newborn infants, with good sensitivity and specificity.

Citing Articles

Enhancing surgical decision-making in NEC with ResNet18: a deep learning approach to predict the need for surgery through x-ray image analysis.

Wu Z, Zhuo R, Liu X, Wu B, Wang J Front Pediatr. 2024; 12:1405780.

PMID: 38895195 PMC: 11183801. DOI: 10.3389/fped.2024.1405780.

Clinical Dilemma Involving Treatments for Very Low-Birth-Weight Infants and the Potential Risk of Necrotizing Enterocolitis: A Narrative Literature Review.

Iijima S J Clin Med. 2024; 13(1).

PMID: 38202069 PMC: 10780023. DOI: 10.3390/jcm13010062.

References

Tracy S, Lazow S, Castro-Aragon I, Fujii A, Estroff J, Parad R . Is Abdominal Sonography a Useful Adjunct to Abdominal Radiography in Evaluating Neonates with Suspected Necrotizing Enterocolitis?. J Am Coll Surg. 2020; 230(6):903-911.e2. DOI: 10.1016/j.jamcollsurg.2020.01.027. View

Kotb M, Abdelatty M, Rashwan H, Abdelmeguid Y, Elrouby A . Intussusception in preterm neonates: A systematic review of a rare condition. BMC Pediatr. 2021; 21(1):587. PMC: 8709945. DOI: 10.1186/s12887-021-03065-5. View

Ben Fadel N, Pulgar L, Khurshid F . Point of care ultrasound (POCUS) in Canadian neonatal intensive care units (NICUs): where are we?. J Ultrasound. 2019; 22(2):201-206. PMC: 6531515. DOI: 10.1007/s40477-019-00383-4. View

Silva C, Daneman A, Navarro O, Moore A, Moineddin R, Gerstle J . Correlation of sonographic findings and outcome in necrotizing enterocolitis. Pediatr Radiol. 2007; 37(3):274-82. DOI: 10.1007/s00247-006-0393-x. View

Faingold R, Daneman A, Tomlinson G, Babyn P, Manson D, Mohanta A . Necrotizing enterocolitis: assessment of bowel viability with color doppler US. Radiology. 2005; 235(2):587-94. DOI: 10.1148/radiol.2352031718. View

Palleri E, Kaiser S, Wester T, Arnell H, Bartocci M . Complex Fluid Collection on Abdominal Ultrasound Indicates Need for Surgery in Neonates with Necrotizing Enterocolitis. Eur J Pediatr Surg. 2016; 27(2):161-165. DOI: 10.1055/s-0036-1580702. View

Cuna A, Reddy N, Robinson A, Chan S . Bowel ultrasound for predicting surgical management of necrotizing enterocolitis: a systematic review and meta-analysis. Pediatr Radiol. 2017; 48(5):658-666. PMC: 5895673. DOI: 10.1007/s00247-017-4056-x. View

Muchantef K, Epelman M, Darge K, Kirpalani H, Laje P, Anupindi S . Sonographic and radiographic imaging features of the neonate with necrotizing enterocolitis: correlating findings with outcomes. Pediatr Radiol. 2013; 43(11):1444-52. DOI: 10.1007/s00247-013-2725-y. View

Epelman M, Daneman A, Navarro O, Morag I, Moore A, Kim J . Necrotizing enterocolitis: review of state-of-the-art imaging findings with pathologic correlation. Radiographics. 2007; 27(2):285-305. DOI: 10.1148/rg.272055098. View

10.

Hwang M, Tierradentro-Garcia L, Dennis R, Anupindi S . The role of ultrasound in necrotizing enterocolitis. Pediatr Radiol. 2021; 52(4):702-715. DOI: 10.1007/s00247-021-05187-5. View

11.

Chen S, Hu Y, Liu Q, Li X, Wang H, Wang K . Comparison of abdominal radiographs and sonography in prognostic prediction of infants with necrotizing enterocolitis. Pediatr Surg Int. 2018; 34(5):535-541. DOI: 10.1007/s00383-018-4256-y. View

12.

Tam A, Camberos A, Applebaum H . Surgical decision making in necrotizing enterocolitis and focal intestinal perforation: predictive value of radiologic findings. J Pediatr Surg. 2002; 37(12):1688-91. DOI: 10.1053/jpsu.2002.36696. View

13.

Taskinlar H, Gundogdu G, Celik Y, Avlan D, Nayci A . Challenging diagnosis between intussusception and necrotizing enterocolitis in premature infants. Pediatr Int. 2014; 56(3):e1-3. DOI: 10.1111/ped.12311. View

14.

Aliev M, Dekhqonboev A, Yuldashev R . Advantages of abdominal ultrasound in the management of infants with necrotizing enterocolitis. Pediatr Surg Int. 2016; 33(2):213-216. DOI: 10.1007/s00383-016-4017-8. View

15.

Alexander K, Chan S, Opfer E, Cuna A, Fraser J, Sharif S . Implementation of bowel ultrasound practice for the diagnosis and management of necrotising enterocolitis. Arch Dis Child Fetal Neonatal Ed. 2020; 106(1):96-103. PMC: 7788207. DOI: 10.1136/archdischild-2019-318382. View

16.

Baird R, Tessier R, Guilbault M, Puligandla P, Saint-Martin C . Imaging, radiation exposure, and attributable cancer risk for neonates with necrotizing enterocolitis. J Pediatr Surg. 2013; 48(5):1000-5. DOI: 10.1016/j.jpedsurg.2013.02.016. View

17.

Chan B, Gordon S, Yang M, Weekes J, Dance L . Abdominal Ultrasound Assists the Diagnosis and Management of Necrotizing Enterocolitis. Adv Neonatal Care. 2021; 21(5):365-370. DOI: 10.1097/ANC.0000000000000919. View

18.

Neu J, Walker W . Necrotizing enterocolitis. N Engl J Med. 2011; 364(3):255-64. PMC: 3628622. DOI: 10.1056/NEJMra1005408. View

19.

Miller L, Stoller J, Fraga M . Point-of-care ultrasound in the neonatal ICU. Curr Opin Pediatr. 2019; 32(2):216-227. DOI: 10.1097/MOP.0000000000000863. View

20.

Faingold R . Technical aspects of abdominal ultrasound and color Doppler assessment of bowel viability in necrotizing enterocolitis. Pediatr Radiol. 2018; 48(5):617-619. DOI: 10.1007/s00247-018-4077-0. View