الفهرس 
Necrotizing enterocolitisOnly 14 pages are availabe for public view
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Abstract
Necrotizing enterocolitis (NEC) is the most common acquired intestinal emergency encountered in the neonatal intensive care unit. NEC is characterized by transmucosal necrosis of a part of the intestine. The very small ill infant that is born before term is most susceptible to NEC and the incidence is increasing because of the improved survival rate in the high risk group of infants born prematurely.
The aim of the work was to detect abdominal sonographic findings in neonates with necrotizing enterocolitis and its role in early diagnosis of NEC. The study was carried out at the NICU of El- Hussein University Hospital, Abu El- Reesh University hospital and Ain-Shams University hospital during the period from April, 2009 to April, 2011.
Patients were categorized into three groups, group 1 includes 15 apparently normal neonates ≤32 weeks, group 2 includes 15 neonates ≤32 weeks with early stage of NEC, group 3 includes 15 neonates ≤32 weeks with late stage of NEC.
Group I consisted of 15 neonates, 8females (53.3%), and 7 males (46.6%), their gestational age ranged from 29-32 weeks, with mean GA 30.6 ± 0.976 weeks, their weights ranged from 1.1-1.6 kg, with mean 1.391± 0.1706kg, with 7 neonates with normal vaginal delivery (46.6%), and their postnatal age ranged from 8-22 days with mean 13.9 ± 4.1 days.
Group II consisted of 15 neonates, 6 females (40%), and 9 males (60%), their gestational age ranged from 29-32weeks, with mean GA 30.27± 1.033weeks, their weights ranged from 1.2-1.6kg, with mean 1.41± 0.118kg, there were 8 normal vaginal delivery (53.3%), and their postnatal age ranged from 7-20 days, with mean 14.2± 4.31 days.
Group III consisted of 15 neonates, 6 females (40%), and 9 males (60%), their gestational age ranged from 29-32weeks, with mean GA 30.53± 0.99weeks, their weights ranged from 1-1.4 kg, with mean 1.193± 0.1033, with 9 neonates with normal vaginal delivery (60%), and their postnatal age ranged from 9-22 days with mean 15.34± 4.81 days.
All cases of the study were subjected to complete history taking, thorough physical examination, and the relevant investigations (CBC, CRP, blood culture, ABG, Na, K, serial abdominal x-rays, and abdominal ultrasonography).
As regard the neonatal risk factors prematurity was very high significant risk factor, hypoxia and RDS were significant risk factors also.
As regard the intestinal manifestations abdominal distention, gastric residual, abscent bowel sounds, bleeding per rectum, abdominal erythema and vomiting were significant early manifestations, while heamatemesis was significant late intestinal manifestation.
AS regard systemic manifestations sluggish Moro’s reflex, apnea, pallor, mottling, respiratory distress, and sclerema were significant early manifestation.
As regard laboratory findings, the blood culture was significant early laboratory finding but with no specific organism.
Anemia, thrombocytopenia, shift to the left, positive CRP, hyponatremia, and acidosis were also significant laboratory findings in NEC.
The serial abdominal X-rays, anteroposterior erect showed gaseous distension was significant X-ray finding, but it is non specific finding for NEC.
The sonographic features showed increased wall echogenecity, intramural air, and increased wall thickness, were significant early sonographic findings in NEC, while ascites, and air under diaphragm were significant late sonographic findings in NEC.