Abdominal ultrasonography in preterm necrotizing enterocolitis. Is it superior to plain radiography?

PurposeTo explore whether abdominal ultrasound (AUS) provide additional information over plain radiography in cases of necrotizing enterocolitis (NEC).MethodsThis study is a prospective study of 30 premature neonates with NEC in our neonatal intensive care unit between August 2010 and November 2011. Fifteen premature control neonates were also included in the study.ResultsPatients were classified into two groups: the first group with suspected NEC (stage I) (n = 14) and the second with definite NEC (stage II or III) (n = 16). In group I abdominal ultrasound (AUS) revealed intramural air (n = 9) and portal venous gas (PVG) (n = 1) while plain radiography showed only gaseous distension. In group II, intramural air (n = 10), PVG (n = 2), free fluid (n = 6) focal fluid (n = 1) and free air (n = 6) detected by AUS compared to pneumatosis intestinalis (PI) (n = 2) PVG (n = 1) and free air (n = 5) by plain radiography. Additionally bowel wall thinning was detected in 2 neonates of group I and 3 of group II.ConclusionOur results suggest AUS to be superior to plain radiography in early detection of complication as intestinal perforation by eliciting PVG and fluid collection and so early surgical management. Therefore this may decrease morbidity and mortality rates.