Eur J Pediatr Surg 2017; 27(02): 161-165
DOI: 10.1055/s-0036-1580702
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Complex Fluid Collection on Abdominal Ultrasound Indicates Need for Surgery in Neonates with Necrotizing Enterocolitis

Elena Palleri
1   Department of Neonatology, Astrid Lindgren Children's Hospital, Stockholm, Sweden
2   Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
,
Sylvie Kaiser
3   Department of Pediatric Radiology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
,
Tomas Wester
4   Department of Pediatric Surgery, Astrid Lindgren Children's Hospital, Stockholm, Sweden
2   Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
,
Henrik Arnell
5   Department of Pediatric Gastroenterology, Hepatology and Nutrition, Astrid Lindgren Children's Hospital, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
2   Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
,
Marco Bartocci
1   Department of Neonatology, Astrid Lindgren Children's Hospital, Stockholm, Sweden
2   Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
› Institutsangaben
Weitere Informationen

Publikationsverlauf

02. November 2015

26. Januar 2016

Publikationsdatum:
28. März 2016 (online)

Abstract

Aim The aim of this study was to determine whether a correlation exists between the sonographic findings and the clinical outcomes, defined as surgery or death, in neonates with radiographically and/or histopathologically confirmed necrotizing enterocolitis (NEC).

Material and Methods In this retrospective study, the case notes of 58 patients admitted to Karolinska University Hospital, Stockholm, Sweden, with radiographically confirmed NEC from September 2010 to August 2013, were reviewed. We included all newborns who underwent both plain abdominal radiographs and an abdominal ultrasound on the same day. The images were reviewed retrospectively. Patients' characteristics, clinical data, and histopathological data were recorded from the case notes. We excluded newborns who developed free gas before surgery. Abdominal ultrasound images were reviewed for free intraperitoneal gas, peritoneal fluid, pneumatosis intestinalis, portal gas, bowel vascularity, bowel wall thickness, and peristalsis. We correlated the sonographic features with the clinical outcomes; defined as the need for surgery or death.

Results Overall, 25 neonates were included. Out of these, 11 patients underwent surgery and 5 patients died. The sonographic finding of complex fluid collection was statistically significant, predicting severe NEC that needed surgery. No other sonographic features were related to the need for surgery or death.

Conclusion Complex fluid collection shown with abdominal ultrasound appears to be strongly correlated to the need for surgery in newborn infants with severe NEC.

 
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