COMPARATIVE STUDY
JOURNAL ARTICLE
Add like
Add dislike
Add to saved papers

Management of NEC: Surgical Treatment and Role of Traditional X-ray Versus Ultrasound Imaging, Experience of a Single Centre.

INTRODUCTION: Necrotizing enterocolitis is the most common cause of the postnatal critical conditions and remains one of the dominant causes of newborns' death in Neonatal Intensive Care. The morbidity and mortality associated with necrotizing enterocolitis remains largely unchanged and the incidence of necrotizing enterocolitis continues to increase. There is no general agreement regarding the surgical treatment of the necrotizing enterocolitis.

METHODS: In this paper, we want to evaluate the results obtained in our centre from different types of necrotizing enterocolitis's surgical treatment and to analyse the role of traditional X-ray versus ultrasound doppler imaging in the evolutionary phases of necrotizing enterocolitis. The study was conducted in the Department of Emergency-Urgency NICU, A.O.R.N. Santobono-Pausilipon in Naples from January 2010 to December 2016. Patients were monitored by hematochemical examinations and radiological orthostatic exams every 12 hours, so that they had a surgical opportunity before intestinal perforation occurred. Ultrasonography was performed to monitor preterm infants who were hospitalized in NICU and that showed NEC symptomatology in phase I Bell staging.

RESULTS: They were recruited 75 premature infants with NEC symptomatology in phase I-III of Bell staging, who underwent surgical or medical treatment. In infants with a birth weight >1500 g (N=30), laparotomy and necrotic bowel resection has generally been our preferred approach. In 46 patients we practiced a primary anastomosis after resection of an isolated necrotic intestinal segment. In patients with multiple areas of necrosis and dubious intestinal vitality, were performed a 'second-look' scheduled after 24 to 48 hours to re-evaluate the intestine. In the initial phase of necrotizing enterocolitis, when the radiographic examination shows only a specific dilation of the loops, ultrasonography shows more and more specific signs, as wall thickening, alteration of parietal echogenicity, increase in wall perfusion, single or sporadic airborne microbubbles in the thickness of wall sections.

CONCLUSIONS: Optimal surgical therapy for NEC begins with adequate antibiotic therapy, reintegration of liquids but above all with timely diagnosis, aimed to discover early prodromic phases of wall damage by US, a fundamental tool. Abdomen radiography shows specificity frameworks only when barrier damage is detected while US provides real-time imaging of abdominal structures, highlighting some elements that are completely excluded by radiograph.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app