eMedicine Specialties > Radiology > Pediatrics

Necrotizing Enterocolitis: Multimedia

Author: Beverly P Wood, MD, MS, PhD, Professor, Departments of Radiology and Pediatrics, Division of Medical Education, Keck School of Medicine, University of Southern California
Contributor Information and Disclosures

Updated: Nov 10, 2008

Multimedia

<STRONG>The radiograph demonstrates multiple dila...Media file 1: The radiograph demonstrates multiple dilated loops in the large bowel and small bowel. Note the pneumatosis intestinalis with bubbly and linear gas collections in the bowel wall.
<STRONG>The radiograph demonstrates multiple dila...

The radiograph demonstrates multiple dilated loops in the large bowel and small bowel. Note the pneumatosis intestinalis with bubbly and linear gas collections in the bowel wall.

<STRONG>Increasing pneumatosis intestinalis is se...Media file 2: Increasing pneumatosis intestinalis is seen in this radiograph.
<STRONG>Increasing pneumatosis intestinalis is se...

Increasing pneumatosis intestinalis is seen in this radiograph.

<STRONG>Anteroposterior image shows necrotizing e...Media file 3: Anteroposterior image shows necrotizing enterocolitis with pneumatosis intestinalis.
<STRONG>Anteroposterior image shows necrotizing e...

Anteroposterior image shows necrotizing enterocolitis with pneumatosis intestinalis.

<STRONG>Lateral abdominal image shows pneumatosis...Media file 4: Lateral abdominal image shows pneumatosis intestinalis.
<STRONG>Lateral abdominal image shows pneumatosis...

Lateral abdominal image shows pneumatosis intestinalis.

This radiograph shows free air secondary to bowel...Media file 5: This radiograph shows free air secondary to bowel wall necrosis.
This radiograph shows free air secondary to bowel...

This radiograph shows free air secondary to bowel wall necrosis.

Left lateral decubitus radiograph shows free air.Media file 6: Left lateral decubitus radiograph shows free air.
Left lateral decubitus radiograph shows free air.

Left lateral decubitus radiograph shows free air.

Portal venous air is present in a patient with pn...Media file 7: Portal venous air is present in a patient with pneumatosis intestinalis.
Portal venous air is present in a patient with pn...

Portal venous air is present in a patient with pneumatosis intestinalis.

<STRONG>Image obtained during examination with a ...Media file 8: Image obtained during examination with a water-soluble enema shows the pneumatosis well. This technique is not recommended.
<STRONG>Image obtained during examination with a ...

Image obtained during examination with a water-soluble enema shows the pneumatosis well. This technique is not recommended.

<STRONG>In this radiograph, free air is observed ...Media file 9: In this radiograph, free air is observed over the liver that outlines the falciform ligament. This finding indicates perforation of the bowel, which necessitates surgical exploration and resection of necrotic bowel.
<STRONG>In this radiograph, free air is observed ...

In this radiograph, free air is observed over the liver that outlines the falciform ligament. This finding indicates perforation of the bowel, which necessitates surgical exploration and resection of necrotic bowel.

More on Necrotizing Enterocolitis

Overview: Necrotizing Enterocolitis
Imaging: Necrotizing Enterocolitis
Multimedia: Necrotizing Enterocolitis
References
Further Reading

References

  1. Chung DH, Ethridge RT, Kim S, Owens-Stovall S, Hernandez A, Kelly DR, et al. Molecular mechanisms contributing to necrotizing enterocolitis. Ann Surg. Jun 2001;233(6):835-42. [Medline].

  2. Claud EC, Walker WA. Hypothesis: inappropriate colonization of the premature intestine can cause neonatal necrotizing enterocolitis. FASEB J. Jun 2001;15(8):1398-403. [Medline].

  3. Di Lorenzo M, Krantis A. Altered nitric oxide production in the premature gut may increase susceptibility to intestinal damage in necrotizing enterocolitis. J Pediatr Surg. May 2001;36(5):700-5. [Medline].

  4. Duro D, Kamin D, Duggan C. Overview of pediatric short bowel syndrome. J Pediatr Gastroenterol Nutr. Aug 2008;47 Suppl 1:S33-6. [Medline].

  5. Hunter CJ, Upperman JS, Ford HR, Camerini V. Understanding the Susceptibility of the Premature Infant to Necrotizing Enterocolitis (NEC). Pediatr Res. Dec 10 2007;[Medline].

  6. Manogura AC, Turan O, Kush ML, Berg C, Bhide A, Turan S. Predictors of necrotizing enterocolitis in preterm growth-restricted neonates. Am J Obstet Gynecol. Jan 11 2008;[Medline].

  7. Buchheit JQ, Stewart DL. Clinical comparison of localized intestinal perforation and necrotizing enterocolitis in neonates. Pediatrics. Jan 1994;93(1):32-6. [Medline].

  8. Casey L, Lee KH, Rosychuk R, Turner J, Huynh HQ. 10-year review of pediatric intestinal failure: clinical factors associated with outcome. Nutr Clin Pract. Aug-Sep 2008;23(4):436-42. [Medline].

  9. Cakmak Celik F, Aygun C, Cetinoglu E. Does early enteral feeding of very low birth weight infants increase the risk of necrotizing enterocolitis?. Eur J Clin Nutr. Nov 28 2007;[Medline].

  10. Premji S, Chessell L. Continuous nasogastric milk feeding versus intermittent bolus milk feeding for premature infants less than 1500 grams. Cochrane Database Syst Rev. 2001;(1):CD001819. [Medline].

  11. Ververidis M, Kiely EM, Spitz L, Drake DP, Eaton S, Pierro A. The clinical significance of thrombocytopenia in neonates with necrotizing enterocolitis. J Pediatr Surg. May 2001;36(5):799-803. [Medline].

  12. Hunter CJ, Petrosyan M, Ford HR, Prasadarao NV. Enterobacter sakazakii: An Emerging Pathogen in Infants and Neonates. Surg Infect (Larchmt). Aug 7 2008;[Medline].

  13. Gagliardi L, Bellù R, Cardilli V, De Curtis M. Necrotising enterocolitis in very low birth weight infants in italy: incidence and non-nutritional risk factors. J Pediatr Gastroenterol Nutr. Aug 2008;47(2):206-10. [Medline].

  14. Bury RG, Tudehope D. Enteral antibiotics for preventing necrotizing enterocolitis in low birthweight or preterm infants. Cochrane Database Syst Rev. 2001;(1):CD000405. [Medline].

  15. Sigalet DL. Short bowel syndrome in infants and children: an overview. Semin Pediatr Surg. May 2001;10(2):49-55. [Medline].

  16. Ng E, Shah VS. Erythromycin for the prevention and treatment of feeding intolerance in preterm infants. Cochrane Database Syst Rev. Jul 16 2008;CD001815. [Medline].

  17. Saxena A, Galwa RP. Sonographic findings and outcome in necrotizing enterocolitis. Pediatr Radiol. Nov 2007;37(11):1180. [Medline].

Further Reading

Evidence-based care guideline for necrotizing enterocolitis (NEC) among very low birth weight infants.
Cincinnati Children's Hospital Medical Center.  2005 Jul 14 (revised 2007 Feb).  12 pages.  NGC:005522
 

Keywords

necrotizing enterocolitis, NEC, neonatal colitis, neonatal enteritis, necrotic appendicitis of the newborn, neonatal gastrointestinal disease, complication of prematurity

Contributor Information and Disclosures

Author

Beverly P Wood, MD, MS, PhD, Professor, Departments of Radiology and Pediatrics, Division of Medical Education, Keck School of Medicine, University of Southern California
Beverly P Wood, MD, MS, PhD is a member of the following medical societies: American Academy of Pediatrics, American Association for Women Radiologists, American College of Radiology, American Institute of Ultrasound in Medicine, American Medical Association, American Roentgen Ray Society, Association of University Radiologists, Radiological Society of North America, and Society for Pediatric Radiology
Disclosure: Nothing to disclose.

Medical Editor

Fredric A Hoffer, MD, FAAP, FSIR, Professor of Radiology, University of Washington; Section Chief of Interventional Radiology, Department of Radiology, Seattle Children's Hospital and Regional Medical Center
Fredric A Hoffer, MD, FAAP, FSIR is a member of the following medical societies: American Academy of Pediatrics, Children's Oncology Group, Radiological Society of North America, Society for Pediatric Radiology, and Society of Interventional Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

David A Stringer, BSc, MBBS, FRCR, FRCPC, Professor, National University of Singapore; Head, Diagnostic Imaging, KK Women's and Children's Hospital, Singapore
David A Stringer, BSc, MBBS, FRCR, FRCPC is a member of the following medical societies: British Columbia Medical Association, Canadian Association of Radiologists, European Society of Paediatric Radiology, Ontario Medical Association, Radiological Society of North America, Royal College of Physicians and Surgeons of Canada, Royal College of Radiologists, and Society for Pediatric Radiology
Disclosure: None None None

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

John Karani, MBBS, FRCR, Consulting Staff, Department of Radiology, King's College Hospital, London
Disclosure: Nothing to disclose.

 
 
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