Ultrasound in necrotizing enterocolitis

Sonographic evaluation of neonates with early-stage necrotizing enterocolitis.

Kim WY, Kim WS, Kim IO, Kwon TH, Chang W, Lee EK

Department of Radiology, CHA Hospital, Pochon CHA University College of Medicine, Seoul, South Korea.

Background: Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in neonatal intensive care units. Ultrasonographic findings in early-stage NEC have not been described. We evaluated the echogenicity of the bowel wall, involved region, ascites, and portal venous gas at both initial and follow-up examinations.

Results: All of the neonates in the control group (n = 10) presented normal bowel wall echogenicity; the patients with NEC presented echogenic dots in 16 patients (40%) and dense granular echogenicities in 24 patients (60%). Portal venous gas was absent in all patients. On the follow-up examinations, the echogenicity of the bowel wall and ascites decreased in 37 patients (93%). The duration of NPO was 11.1 +/- 6.6 days in group I and 16.5 +/- 7.2 days in group II.

Conclusion: Echogenic dots or dense granular echogenicities in the bowel wall can be seen in patients with early-stage NEC. Bowel sonography can be helpful for the early diagnosis and monitoring of patients with NEC.

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Pediatr Radiol. 2005 Aug 3; [Epub ahead of print]