J Korean Soc Neonatol.  2007 Nov;14(2):187-191.

The Importance of Gases in Portal Veins and Liver Parenchyme is Characterized by Liver Ultrasonography in Full-term Neonates with Necrotizing Enterocolitis

• Nam JH
• Lee IK
• Kim YT
• Oh MH

Abstract

PURPOSE: Although early treatment of neonatal necrotizing enterocolitis (NEC) is very important, there exists no definite way of diagnosing NEC at an early stage. Previous reports argue that gases in portal veins and liver parenchyme are detected by liver ultrasonography (USG) even when no symptoms corresponding to NEC are provoked. This study demonstrates the importance of liver USG for early diagnosis of NEC.
METHODS
Abdominal USG was performed on 1381 newborn infants who were admitted to the neonatal intensive care unit of Soonchunhyang University Cheonan Hospital between February 2003 and September 2005. Twelve infants were diagnosed with NEC by liver USG and their individual pathologies were compared.
RESULTS
All of the patients described here were full-term and the most frequent symptom observed was watery diarrhea; four had no symptoms at all. Severe metabolic acidosis was seen in two patients, a rise of C-reactive protein (CRP) in five patients and rotavirus antigen positivity in five patients. One of the patients showed portal vein gas, pneumatosis intestinalis and ileus in a simple abdominal radiography and another patient showed ileus only. However, all of the other 10 patients presented with no abnormal symptoms, according to simple abdominal radiography.
CONCLUSION
NEC should be considered in neonates with gases present in portal veins, intestinal walls and liver parenchyme, as detected by liver USG even when no symptoms corresponding to NEC are provoked.

Keyword

Necrotizing enterocolitis; Portal vein gas; Liver ultrasonography

MeSH Terms

Acidosis
C-Reactive Protein
Chungcheongnam-do
Diarrhea
Early Diagnosis
Enterocolitis, Necrotizing*
Gases*
Humans
Ileus
Infant
Infant, Newborn*
Intensive Care, Neonatal
Liver*
Pathology
Portal Vein*
Radiography, Abdominal
Rotavirus
Ultrasonography*
C-Reactive Protein
Gases