US for Evaluation of Acute Abdominal Conditions in Neonates

Applications of Point-of-Care-Ultrasound in Neonatology: A Systematic Review of the Literature

“…Moreover, it is instrumental in diagnosing neonatal ileus, which is characterized by bowel distension, reduced peristalsis, thinning of bowel wall thickness to less than 1 mm, and loss of normal layering of the bowel. This results in the hyperechogenicity of mucosa and muscularis propria, along with thickened parallel valvulae conniventes, which manifests as a distinctive ‘zebra’ pattern [ 51 ].…”

“…Additionally, portal venous gas appears as intravenous echogenic foci moving with the blood flow, while pneumoperitoneum is identified based on the peritoneal stripe sign. Loss of normal bowel wall layering, free peritoneal fluid, thickening, and secondary thinning of the bowel wall, hyperemia, and a secondary decrease in vascularization due to necrosis can be observed with a note of caution regarding perforation [ 2 , 21 , 22 , 36 , 50 , 51 ].…”

“…Meconium peritonitis can result from in utero bowel perforation and presents antenatally with fetal ascites, dilated intestinal loops, intraabdominal calcifications, echogenic bowel, polyhydramnios, and pseudocysts. Postnatally, ultrasound reveals a dilated proximal to inspissated meconium bowel, distal dilated bowel, homogenous and anechoic ascites with internal septa, a snowstorm appearance in perforation cases, meconium pseudocysts, and pneumoperitoneum [ 51 ].…”

“…In cases of incarcerated inguinal hernia, abdominal POCUS shows a segment of the intestine presenting with wall thickening and hyperechogenicity. Color Doppler and microvascular US aid in differentiating incarcerated and strangulated hernias by identifying the absence of internal vascularity [ 51 ]. Intussusception can be visualized in a transverse view, revealing a target or doughnut-like mass, and in a longitudinal view, showing the pseudokidney sign [ 52 ].…”

“…Intussusception can be visualized in a transverse view, revealing a target or doughnut-like mass, and in a longitudinal view, showing the pseudokidney sign [ 52 ]. Malrotation with a midgut volvulus can be assessed using abdominal POCUS by examining the relationship between the small mesenteric artery and vein, identifying distal duodenal obstruction and proximal duodenal dilatation, non-retroperitoneal position of the third portion of the duodenum, and the whirlpool sign [ 51 ]. In contrast, the segmental intestinal volvulus is unrelated to malrotation and shows a normal orientation of the small mesenteric arteria and vein, a normal retroperitoneal course of the third portion of the duodenum, and a normal midgut rotation [ 51 ].…”