Comprehensive radiological diagnosis of necrotizing enterocolitis in newborns
Journal Title: Здоров`я дитини - Year 2018, Vol 13, Issue 0
Abstract
Background. Necrotic (necrotizing) enterocolitis (NEC) (P77) is a non-specific inflammatory disease caused by infectious agents against the background of immaturity of local defense mechanisms and/or hypoxic-ischemic damage to the intestinal mucosa prone to generalization with the development of systemic inflammatory response. The purpose of the study is to determine the X-ray and ultrasound symptoms of NEC in newborns depending on the stage of the disease. Materials and methods. X-ray and ultrasound data of the abdominal organs were analyzed in 32 newborns, of which 28 (87.5 %) were preterm, 4 (12.5 %) — full-term. Results. NEC stage 1 has been detected in 18.8 % of cases: hyperpneumatosis of the intestine — in 16.7 %, loops in the form of “staples”, thickening of the intestinal walls — in 83.3 %; small horizontal levels of liquid with gas over them — in 33.3 %. Ultrasound examination revealed thickening of the intestinal walls, decreased peristalsis in the affected segments. NEC stage 2 was diagnosed in 31.3 % of cases: rigid bowel loops — in 30 %; static bowel loops — in 40 %. During ultrasound examination, thickening of the intestinal walls was detected, as well as decreased peristalsis in the affected segments, and the presence of transparent effusion. Color flow mapping revealed an amplified or hyperemic type of blood flow in the intestinal wall. NEC stage 3 was diagnosed in 28.1 % of cases: pneumatosis of the gut wall — in 77.8 %; against the background of the shadow of the liver — air in the branches of the portal vein (33.3 %). Ultrasound examination revealed: signs of inflammation in the intestinal wall (77.8 %); pneumatosis of the bowel wall (88.9 %) and distribution of gas in the portal vein (44.4 %). In NEC stage 4 (21.9 %), pneumoperitoneum was detected. Conclusions. The main objective of the radiation study of children with NEC is the detection of the entire set of manifestations that allow diagnosing the disease as early as possible and determining the adequate treatment for the patient. Ultrasound examination should be performed for all patients, especially with nonspecific X-ray or questionable clinical signs of NEC.
Authors and Affiliations
V. V. Shapovalova, O. P. Sharmazanova, M. O. Bortnyi, G. R. Skoryk
Clinical Observation of a Child with KID (Keratitis-Ichthyosis-Deafness) Syndrome
A clinical case of keratitis-ichthyosis-deafness (KID syndrome) in an infant is described. The article familia-rizes pediatricians and family doctors with difficulties in the diagnosis of this rare genetic disease in inf...
Features of Cytological Profile of Induced Sputum in School-Age Children with Exercise-Induced Bronchial Asthma
On the basis of Regional children’s clinical hospital of Chernivtsi, in 41 school-age children with persistent bronchial asthma (BA), the nature of airways inflammation has been studied with the aim of differential choic...
Antibiotic therapy of community-acquired pneumonia in children: comparison of international guidelines and current practice in Ukraine
Background. Respiratory diseases are a serious medical and social problem in pediatrics. The aim of the study was to research the current scientific sources for the treatment of community-acquired pneumonia in children,...
Use of Ursodeoxycholic Acid for the Treatment of Biliary Dysfunction in Children
The article discusses the positive experience of using Ukrliv containing ursodeoxycholic acid in children with functional biliary disorders.
Bronchopulmonary dysplasia in children: contemporary diagnosis, consequences and their treatment (update 2017)
The article deals with the modern principles of diagnosing bronchopulmonary dysplasia (BPD) in children based on the guidelines of the American Thoracic and European Respiratory Societies. The article have aim to provide...