Bowel Dilatation on Initial Plane Abdominal Radiography May Help to Assess the Severity of Necrotizing Enterocolitis in Preterm Infants.

Zlatan Zvizdic,Semir Vranic,Nedzad Rustempasic,Amra Dzananovic,Irmina Sefic Pasic,Asmir Jonuzi,Emir Milisic

doi:10.3390/children7020009

Zlatan Zvizdic, Semir Vranic + Show 5 more

Open Access

https://doi.org/10.3390/children7020009

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Abstract

Background: Necrotizing enterocolitis (NEC) is the most common life-threatening gastrointestinal emergency associated with prematurity. Timely diagnosis and adequate treatment are crucial to reduce the morbidity and mortality of the affected infants. The aim of this study was to evaluate the diagnostic yield of bowel dilatation on plane abdominal radiography (AR) in the early diagnosis and NEC severity in preterm infants. Methods: We retrospectively reviewed initial ARs of 50 preterm infants with NEC ≥ stage II admitted to the neonatal intensive care unit (NICU) in a tertiary-care hospital. The largest bowel loops diameters (AD), the latero-lateral diameters of the peduncle of the first lumbar vertebra (L1), and the distance of the upper edge of the first lumbar vertebra and the lower edge of the second one, including the disc space (L1–L2), were measured. All anteroposterior ARs were done in a supine projection on the day of onset of the initial symptoms of NEC. Results: Preterm infants with surgical NEC showed a statistically significant increase in the AD/L1 ratio (p < 0.001) and AD/L1-L2 ratio (p < 0.001) compared with preterm infants with medical NEC. We found no significant association between the site of the most distended bowel loop and the severity of NEC (p > 0.05). Conclusion: Bowel loop distension on initial AR may serve as an additional diagnostic tool in the early diagnosis and severity of stages II/III NEC. Further prospective clinical studies should validate the results from this study.

Highlights

Necrotizing enterocolitis (NEC) is the most common life-threatening gastrointestinal emergency in newborns that may require surgical treatment [1]
All the patients were treated at the neonatal intensive care unit with surgical NEC (≥stage II)
In we explored the ratio between the upper edge of the first lumbar vertebra and the lower edge of the addition, we explored the ratio between the upper edge of the first lumbar vertebra and the lower second one, including the disc space (L1–L2) (Figure 2)

Summary

Introduction

Necrotizing enterocolitis (NEC) is the most common life-threatening gastrointestinal emergency in newborns that may require surgical treatment [1]. Delay of NEC diagnosis and treatment may aggravate this acquired medical condition. NEC diagnosis is based on the evidence of systemic and intestinal signs. Necrotizing enterocolitis (NEC) is the most common life-threatening gastrointestinal emergency associated with prematurity. Diagnosis and adequate treatment are crucial to reduce the morbidity and mortality of the affected infants. The aim of this study was to evaluate the diagnostic yield of bowel dilatation on plane abdominal radiography (AR) in the early diagnosis and NEC severity in preterm infants. Methods: We retrospectively reviewed initial ARs of 50 preterm infants with NEC ≥ stage II admitted to the neonatal intensive care unit (NICU) in a tertiary-care hospital. Results: Preterm infants with surgical NEC showed a statistically significant increase in the AD/L1 ratio (p < 0.001) and AD/L1-L2 ratio (p < 0.001) compared with preterm infants with medical

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