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Pediatric Radiology

, Volume 37, Issue 3, pp 274–282 | Cite as

Correlation of sonographic findings and outcome in necrotizing enterocolitis

  • Cicero T. Silva
  • Alan Daneman
  • Oscar M. Navarro
  • Aideen M. Moore
  • Rahim Moineddin
  • J. Ted Gerstle
  • Ashok Mittal
  • Mary Brindle
  • Monica Epelman
Original Article

Abstract

Background

There is little in the literature regarding the use of gray-scale and Doppler sonography of the bowel in necrotizing enterocolitis (NEC) and how findings depicted by this modality might assist in predicting outcome and influence management.

Objective

To correlate sonographic findings with outcome in NEC.

Materials and methods

This was a retrospective analysis of clinical and abdominal ultrasonography (AUS) findings in NEC from January 2003 to December 2005. AUS findings were evaluated for portal venous gas, free gas, peritoneal fluid, bowel wall thickness, echogenicity, perfusion and intramural gas. Patients were categorized into two groups, according to their outcome.

Results

A total of 40 infants were identified who had AUS for NEC prior to any surgical intervention. Group A comprised 18 neonates treated medically and recovered fully, and group B comprised 22 neonates who required surgery or died. Free gas (six patients) and focal fluid collections (three patients) were only found in group B. Increased bowel wall echogenicity, absent bowel perfusion, portal venous gas, bowel wall thinning, bowel wall thickening, free fluid with echoes and intramural gas were seen in both groups, but more frequently in group B. Anechoic free fluid was seen more frequently in group A. Increased bowel perfusion was seen equally in both groups.

Conclusion

An adverse outcome was associated with the sonographic findings of free gas, focal fluid collections or three or more of the following: increased bowel wall echogenicity, absent bowel perfusion, portal venous gas, bowel wall thinning, bowel wall thickening, free fluid with echoes and intramural gas. Sonographic findings are useful in predicting outcome and therefore might help guide management.

Keywords

Necrotizing enterocolitis Sonography Neonates 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Cicero T. Silva
    • 1
  • Alan Daneman
    • 1
  • Oscar M. Navarro
    • 1
  • Aideen M. Moore
    • 2
  • Rahim Moineddin
    • 3
  • J. Ted Gerstle
    • 4
  • Ashok Mittal
    • 2
  • Mary Brindle
    • 4
  • Monica Epelman
    • 1
  1. 1.Department of Diagnostic Imaging, The Hospital for Sick ChildrenUniversity of TorontoTorontoCanada
  2. 2.Division of Neonatology, The Hospital for Sick ChildrenUniversity of TorontoTorontoCanada
  3. 3.Department of Family and Community Medicine, The Hospital for Sick ChildrenUniversity of TorontoTorontoCanada
  4. 4.Division of General Surgery, The Hospital for Sick ChildrenUniversity of TorontoTorontoCanada

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