ARRS 2022 Abstracts

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E1773. Bowel Ultrasound Features of Necrotizing Enterocolitis in the Preterm Infant
Authors
  1. Mohammed Ali; Henry Ford Hospital
  2. Joseph Joshua; Henry Ford Hospital
  3. Rishika Polasani; Wayne State University
  4. Denise Collins; Henry Ford Hospital
  5. Gauravi Sabharwal; Henry Ford Hospital
  6. Karyn Ledbetter; Henry Ford Hospital
  7. Jessica Leschied; Henry Ford Hospital
Background
Necrotizing enterocolitis (NEC) is a life-threatening condition of the neonatal gastrointestinal tract secondary to inflammation, infection, and ischemia. Prompt diagnosis is critical as mortality rate is much higher after perforation. Radiographs are currently the first-line imaging for evaluating for NEC; however, they may be nonspecific or inconclusive. Although bowel ultrasound is not routinely done to evaluate for NEC due to limited awareness of its utility among radiologists and clinicians, it can serve as an adjunct to radiography and clinical data.

Educational Goals / Teaching Points
Upon completion of this educational exhibit, the learner will become familiar with a bowel ultrasound protocol for a neonate with suspected NEC. They will recognize what normal neonatal bowel looks like on sonography. Finally, they will identify bowel ultrasound features of NEC and associated complications.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Bowel ultrasound can identify intramural gas, portal venous gas, and intraperitoneal free air and allows for evaluation of bowel wall perfusion, bowel wall thickening and thinning, bowel peristalsis, fluid collections, and ascites.

Conclusion
Plain radiography has its limitations when it comes to evaluating for NEC. Ultrasound has many advantages compared to radiographs including evaluation of bowel wall perfusions and thickness, and fluid. At our institution, bowel ultrasound is performed when plain radiographs are inconclusive and often leads to earlier detection of NEC, potentially improving outcomes.