Role of Abdominal Ultrasonography in the Early Diagnosis of Neonatal Necrotizing Enterocolitis

Introduction: Necrotizing enterocolitis (NEC) can be defined as inflammatory intestinal disease characterized by variable degree of damage to the intestinal tract, ranging from mucosal injury to full-thickness necrosis and perforation (Obladen 2009). Aim of the work: to evaluate patients with suspected or proven NEC by abdominal and Doppler ultrasound to examine the usefulness of abdominal ultrasound and color Doppler ultrasound in early diagnosis of Necrotizing Enterocolitis. Patients and Methods: Prospective hospital based study that is conducted at Neonatal intensive care unit (N.I.C.U) at Sohag University Hospital. The study Period is from 31th October 2015 to 30th April 2016.  All neonates with clinical, radiological findings suggesting necrotizing enterocolitis were included in the study.  Results: A total of 20 neonates had met the inclusion criteria. Patients had variable clinical presentation, most common presentation was abdominal distension and brownish vomiting 35% of patients; 80% of patients had tense abdomen; 80% of patients had dullness of the abdomen; 80% had inaudible intestinal sounds and 20% had sluggish intestinal sounds. By Abdominal US Pneumatosis intestinalis was detected in 50% of cases in which 30% were diffuse and 20% were segmental in contrast to X ray that detected only 35% of cases (p value 0.003). Portal venous gas was detected in 25% of cases by US in comparison to only 10% by X ray with p value of 0.001. Conclusion: Abdominal ultrasound and color Doppler ultrasound were helpful in detecting cases with early stage of NEC. Abdominal ultrasound was helpful in early detection of complication as intestinal perforation and so early surgical management; thus may decrease morbidity and mortality rates.