Sonographic Findings in a Model of Ischemia-Induced Necrotizing Enterocolitis With Pathological Correlations

Kim, Wha-Young; Kim, In-One; Kim, Woo Sun; Yeon, Kyung Mo; Kim, Gwang Il; Lee, Sun Wha; Suh, Jin Soo; Choi, Hye-Young; Chang, Kyujin

doi:10.1097/01.rli.0000258681.14275.19

Cited by 11 publications

(11 citation statements)

References 26 publications

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“…The amount of intramural gas may vary between only a few foci and involvement of the whole circumference of the bowel, that is, the ‘circle sign’,18 thus making the normal structure of the bowel wall unrecognisable. Animal studies confirmed the correlation of this sonographic finding with histopathological findings of NEC 19. PI is most commonly seen in the distal small bowel and the colon.…”

Section: Intramural Gassupporting

confidence: 75%

Usefulness of abdominal ultrasound in diagnosing necrotising enterocolitis

Bohnhorst

2013

Arch Dis Child Fetal Neonatal Ed

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Necrotising enterocolitis is a serious disorder in preterm infants with a mortality of up to 60%. Therefore, early and precise diagnosis and rapid initiation of proper treatment are essential. Clinically suspected diagnosis is usually confirmed by typical findings on plain abdominal radiograph, for example, pneumatosis intestinalis, portal venous gas and, in case of intestinal perforation, pneumoperitoneum. Recently, there has been growing evidence that with real-time ultrasound, intramural air and portal gas can be better detected than with x-ray. Furthermore, ultrasound is able to assess the bowel wall directly and detect bowel wall thickening or thinning, reduced peristalsis or disturbed bowel wall perfusion. Intra-abdominal fluid, both intraluminal or extraluminal is also visible. However, data regarding the diagnostic validity and prognostic value of abdominal ultrasound are limited and often focused on a single finding rather than a combination of them. Additionally, until now, ultrasound findings seem to have little influence on therapeutic decisions. Therefore, the value of abdominal ultrasound in the diagnosis of necrotising enterocolitis has to be determined by further studies until its use can be generally recommended.

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Section: Intramural Gassupporting

confidence: 75%

Usefulness of abdominal ultrasound in diagnosing necrotising enterocolitis

Bohnhorst

2013

Arch Dis Child Fetal Neonatal Ed

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“…We did not attempt to describe a pattern of PI nor to quantify or grade the severity of the PI in our foals because of the retrospective nature of the study. Intramural gas may involve any part of the GI tract in human NEC but is more commonly present in the distal small bowel and large bowel and imaged more commonly in the right lower quadrant (Kim et al . 2007).…”

Section: Discussionmentioning

confidence: 99%

“…2007). Radiographic documentation of PI is the current standard to confirm NEC diagnosis in man, but the sonographic detection of PI has been shown to be both sensitive and specific (Kim et al . 2007) and to have a growing and evolving role in the evaluation of these patients (Epelman et al .…”

Section: Introductionmentioning

confidence: 99%

The importance of ultrasonographic pneumatosis intestinalis in equine neonatal gastrointestinal disease

Solís

Palmer

Boston

et al. 2012

Equine Veterinary Journal

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SummaryReasons for performing study: Recognising the presence of a necrotising component of the gastrointestinal disease may be clinically useful in ill equine neonates. Objectives: To study the importance of abdominal sonograms in neonatal foals suffering from gastrointestinal conditions and to describe the clinical features of necrotising gastrointestinal disease. Hypothesis: There is a subgroup of neonates with sonographically detectable pneumatosis intestinalis (PI), reflecting a necrotising disease. Methods: Records of foals aged Յ7 days hospitalised from 2005 to 2009 with signs of gastrointestinal disease were evaluated (n = 89). The association of sonographic, clinical and clinicopathological signs with necrotising gastrointestinal disease and outcome was determined. Results: PI was imaged in 19 foals. Twenty-seven foals were classified as having necrotising gastrointestinal disease based on the presence of gastrointestinal signs (colic, diarrhoea, gastric reflux or abdominal distension) and sonographic PI (n = 19), surgical (n = 2) or pathological (n = 6) evidence of gastrointestinal necrosis. There was a difference between survival rate in foals with and without necrotising disease (33.3 and 69.4%, respectively, P = 0.005) or foals with and without PI detected sonographically (36.8 and 72.1%, respectively, P = 0.023). PI was the only sonographic finding associated with outcome. Prematurity, the presence of blood in the faeces, gastric reflux, abdominal distension, abnormal echogenicity of the colon and the lowest white blood cell count during hospitalisation were associated with necrotising gastrointestinal disease (P<0.05). Conclusions and potential relevance: Abdominal sonograms have prognostic value in neonatal gastrointestinal disease. PI and the presence of necrotising gastrointestinal disease were common and associated with a poor prognosis.

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“…Various papers described the US findings of ischemic bowel, in particular in children with necrotizing enterocolitis [9, 10, 18]. A variety of diagnoses are known to have intramural gas (bowel necrosis from vascular hypoperfusion, occluded or impaired venous drainage, necrotizing enterocolitis, chronic bronchitis and asthma, inflammatory bowel disease, ulcer disease and diverticulitis and collagen vascular disease) [9–13] In the radiological evaluation of large bowel intussusception the finding of intramural gas is likely related to ischemic bowel.…”

Section: Discussionmentioning

confidence: 99%

Intramural and subserosal echogenic foci on US in large-bowel intussusceptions: prognostic indicator for reducibility?

et al. 2008

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Sonographic Findings in a Model of Ischemia-Induced Necrotizing Enterocolitis With Pathological Correlations

Abstract: ED or CGE are the sonographic findings of ischemic enterocolitis, and bowel wall echogenicity might reflect the degree of ischemic injury.

Cited by 11 publications

References 26 publications

Usefulness of abdominal ultrasound in diagnosing necrotising enterocolitis

Usefulness of abdominal ultrasound in diagnosing necrotising enterocolitis

The importance of ultrasonographic pneumatosis intestinalis in equine neonatal gastrointestinal disease

Intramural and subserosal echogenic foci on US in large-bowel intussusceptions: prognostic indicator for reducibility?

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