pediatrics
Necrotizing Enterocolitis
Diagnosis of Necrotizing Enterocolitis
Detection of blood in stool Abdominal x-rays Ultrasonography Sometimes, blood is detected in the stool. Early x-rays may be nonspecific and reveal only ileus. However, a fixed, dilated intestinal loop (sentinel loop) that does not change on repeated x-rays is very concerning for NEC. X-ray signs diagnostic of NEC are pneumatosis intestinalis and portal vein gas. Pneumoperitoneum indicates bowel perforation and an urgent need for surgery. Ultrasonography is being used increasingly in cases of NEC. With ultrasonography, clinicians have the ability to look at bowel wall thickness, pneumatosis intestinalis, and blood flow. This technique, however, is very operator dependent, and plain x-rays are still more commonly used. 