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Open AccessBrief Report

Bowel Dilatation on Initial Plane Abdominal Radiography May Help to Assess the Severity of Necrotizing Enterocolitis in Preterm Infants

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Clinic of Pediatric Surgery, University Clinical Center Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
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Department of Radiology, University Clinical Center Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
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Clinic of Cardiovascular Surgery, University Clinical Center Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
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College of Medicine, QU Health, Qatar University, Doha PO Box 2713, Qatar
*
Author to whom correspondence should be addressed.
Children 2020, 7(2), 9; https://doi.org/10.3390/children7020009
Received: 10 December 2019 / Revised: 23 December 2019 / Accepted: 6 January 2020 / Published: 23 January 2020
(This article belongs to the Section Pediatric Surgery)
Background: Necrotizing enterocolitis (NEC) is the most common life-threatening gastrointestinal emergency associated with prematurity. Timely diagnosis and adequate treatment are crucial to reduce the morbidity and mortality of the affected infants. The aim of this study was to evaluate the diagnostic yield of bowel dilatation on plane abdominal radiography (AR) in the early diagnosis and NEC severity in preterm infants. Methods: We retrospectively reviewed initial ARs of 50 preterm infants with NEC ≥ stage II admitted to the neonatal intensive care unit (NICU) in a tertiary-care hospital. The largest bowel loops diameters (AD), the latero-lateral diameters of the peduncle of the first lumbar vertebra (L1), and the distance of the upper edge of the first lumbar vertebra and the lower edge of the second one, including the disc space (L1–L2), were measured. All anteroposterior ARs were done in a supine projection on the day of onset of the initial symptoms of NEC. Results: Preterm infants with surgical NEC showed a statistically significant increase in the AD/L1 ratio (p < 0.001) and AD/L1-L2 ratio (p < 0.001) compared with preterm infants with medical NEC. We found no significant association between the site of the most distended bowel loop and the severity of NEC (p > 0.05). Conclusion: Bowel loop distension on initial AR may serve as an additional diagnostic tool in the early diagnosis and severity of stages II/III NEC. Further prospective clinical studies should validate the results from this study.
Keywords: necrotizing enterocolitis; abdominal radiography; bowel distension; disease severity necrotizing enterocolitis; abdominal radiography; bowel distension; disease severity
MDPI and ACS Style

Zvizdic, Z.; Sefic Pasic, I.; Dzananovic, A.; Rustempasic, N.; Milisic, E.; Jonuzi, A.; Vranic, S. Bowel Dilatation on Initial Plane Abdominal Radiography May Help to Assess the Severity of Necrotizing Enterocolitis in Preterm Infants. Children 2020, 7, 9.

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