Pediatric Surgery International

, Volume 27, Issue 3, pp 321–327 | Cite as

Does abdominal sonography provide additional information over abdominal plain radiography for diagnosis of necrotizing enterocolitis in neonates?

  • Dilek Dilli
  • Ş. Suna Oğuz
  • Reyhan Erol
  • Hülya Özkan-Ulu
  • Hüseyin Dumanlı
  • Uğur Dilmen
Original Article



To explore whether addition of abdominal sonography (AUS) to plain radiography is helpful in the management of premature newborns with necrotizing enterocolitis (NEC).


This study is a prospective analysis of 93 premature neonates with NEC who were followed-up in our neonatal intensive care unit between October 2007 and April 2009.


Patients were classified into two groups; group I with suspected NEC (stage I) (n = 54) and group II with definite NEC (stage ≥II) (n = 39). Pneumatosis intestinalis (PI) (n = 29), free air (n = 9), and portal venous gas (PVG) (n = 1) were observed in group II on plain radiography. In the same group, echoic free fluid (EFF) (n = 9), PVG (n = 6), PI (n = 5), and focal fluid collection (n = 3) were the most prominent sonographic findings. In patients with intestinal perforation, whereas EFF and bowel wall thinning were observed on AUS, free air was not detected on plain radiography as a sign of intestinal perforation.


Our results suggest AUS to be superior to plain radiography on early detection of intestinal perforation by demonstrating PVG and EFF collection. Therefore, it may be life-saving by directing the surgeon to perform surgical intervention in the case of clinical deterioration in the course of NEC.


Newborn Necrotizing enterocolitis Abdominal sonography 


Conflict of interest



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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Dilek Dilli
    • 1
    • 3
  • Ş. Suna Oğuz
    • 1
  • Reyhan Erol
    • 1
  • Hülya Özkan-Ulu
    • 1
  • Hüseyin Dumanlı
    • 2
  • Uğur Dilmen
    • 1
  1. 1.Department of NeonatologyZekai Tahir Burak Maternity and Teaching HospitalAnkaraTurkey
  2. 2.Department of RadiologyZekai Tahir Burak Maternity and Teaching HospitalAnkaraTurkey
  3. 3.Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi, Yenidoğan KliniğiAnkaraTurkey

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