Answer to Quiz No. 43/2015 dated 03 Jan 2016

NECROTISING ENTEROCOLLITIS (NEC)

Necrotizing enterocolitis (NEC) is a common acute abdominal condition seen in the neonatal period. Early diagnosis, which relies on imaging findings, and institution of prompt therapy are essential to limit morbidity and mortality.

Ultrasound
Bowel wall thickness, echogenicity, peristalsis, and perfusion in the normal neonate and in those with NEC
Bowel viability with color Doppler sonography in neonates with NEC

Plain abdominal radiograph
Primarily to the presence, amount, and distribution of gas, which includes intraluminal gas, intramural gas, portal venous gas, and free intraperitoneal gas

Serial radiographs of a neonate 
Disappearance of intramural gas and portal venous gas is not a good indicator of clinical progress. The images also show a decrease in the amount of intraluminal gas, which persists as fixed, dilated loops. This appearance is an ominous sign, suggesting the presence of necrotic loops. At no time was there evidence of free intraperitoneal gas.

​Contributed By:
Dr.P.M.VENKATA SAI.M.B.B.S.D.M.R.D.D.N.B. F.I.C.R. Ph.D 
SRMC&RI ,SRI RAMACHANDRA UNIVERSITY ,PORUR, CHENNAI