Prognostic value of abdominal sonography in necrotizing enterocolitis of premature infants born before 33 weeks gestational age

ObjectiveThe purpose of this study was to assess the prognostic value of abdominal sonography in necrotizing enterocolitis (NEC) in preterm infants with a gestational age less than 33 weeks of gestation, using surgery and/or death as the primary outcome and stenosis as the secondary outcome.MethodsA retrospective study of 95 premature infants (mean gestational age: 28.6 weeks), presenting with NEC between January 2009 and November 2011 and who underwent plain abdominal radiography and sonography, was performed. In uni- and multivariate analyses, radiographic and sonographic findings were correlated with complications (‘surgery and/or death’ and ‘stenosis’).ResultsSonographic findings of free intraperitoneal air (odd ratio [OR] = 8.0; IC, 1.4–44.2), free abdominal fluid (OR 3.5; IC 1.3–9.4), portal venous gas (OR 3.9; IC, 1.2–12.9), and bowel wall thickening (OR 2.8; IC,1.1–7.2) were significantly associated with surgery and/or death. Intramural gas was significantly correlated (OR = 11.8; IC, 1.5–95.8) with intestinal stenosis following NEC. None of the radiographic findings were associated with complications.ConclusionAbdominal sonography is a reliable tool for the prognostic assessment of NEC in preterm infants.