2014 · JOURNAL OF PEDIATRIC SURGERY

Prognostic value of abdominal sonography in necrotizing enterocolitis of premature infants born before 33 weeks gestational age

Garbi-Goutel, Aurelie, Brevaut-Malaty, Veronique, Panuel, Michel, Michel, Fabrice, Merrot, Thierry, Gire, Catherine

Journal
JOURNAL OF PEDIATRIC SURGERY
Année
2014
Volume
49
Numéro
4
Pages
508-513
Mois
APR
DOI
10.1016/j.jpedsurg.2013.11.057

Abstract

Objective: The purpose of this study was to assess the prognostic value of abdominal sonography in necrotizing enterocolitis (NEC) in preterm infants with a gestational age less than 33 weeks of gestation, using surgery and/or death as the primary outcome and stenosis as the secondary outcome. Methods: A retrospective study of 95 premature infants (mean gestational age: 28.6 weeks), presenting with NEC between January 2009 and November 2011 and who underwent plain abdominal radiography and sonography, was performed. In uni- and multivariate analyses, radiographic and sonographic findings were correlated with complications ('surgery and/or death' and `stenosis'). Results: Sonographic findings of free intraperitoneal air (odd ratio [OR] = 8.0; IC, 1.4-44.2), free abdominal fluid (OR 3.5; IC 1.3-9.4), portal venous gas (OR 3.9; IC, 1.2-12.9), and bowel wall thickening (OR 2.8; IC, 1.1-7.2) were significantly associated with surgery and/or death. Intramural gas was significantly correlated (OR = 11.8; IC, 1.5-95.8) with intestinal stenosis following NEC. None of the radiographic findings were associated with complications. Conclusion: Abdominal sonography is a reliable tool for the prognostic assessment of NEC in preterm infants. (C) 2014 Elsevier Inc. All rights reserved.

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