Advertisement

Pediatric Radiology

, Volume 18, Issue 1, pp 24–27 | Cite as

Use of the barium enema in the diagnosis of necrotizing enterocolitis

  • P. Uken
  • W. Smith
  • E. A. Franken
  • E. Frey
  • Y. Sato
  • C. Ellerbroek
Originals

Abstract

Necrotizing enterocolitis (NEC) is associated with considerable morbidity and mortality in infants. The diagnosis relies heavily upon radiographic and clinical features. Failure to accurately diagnose NEC is associated with a risk of complications and death, however overdiagnosis also causes both morbidity and mortality as well as excessive medical costs. This report documents the use of barium enema to evaluate suspected clinical or radiographic NEC in 31 premature infants with ambiguous clinical and radiographic signs. The enema was normal in 26 infants and no treatment for NEC was given. Only one of these infants developed signs of NEC subsequent to the examination. Five infants had radiographic evidence of colitis including small ulcerations, spasm, intramural extravasation of barium and mucosal irregularity. Two of the five positive cases are pathologically documented. The barium enema can represent a significant improvement in the specificity of the diagnosis of NEC. Its greatest value is in the exclusion of NEC in ambiguous cases.

Keywords

Public Health Barium Premature Infant Medical Cost Positive Case 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Kliegman RM, Fanaroff AA (1984) Necrotizing enterocolitis. NEJM 310: 1093PubMedGoogle Scholar
  2. 2.
    Santulli TV, Schullinger JN, Heird WC et al. (1975) Acute necrotizing enterocolitis in infancy: a review of 64 cases. Pediatrics 55: 376PubMedGoogle Scholar
  3. 3.
    Rabinowitz JG, Siegle RL (1976) Changing clinical and roentgenographic pattens of necrotizing enterocolitis. AJR 126: 560PubMedGoogle Scholar
  4. 4.
    Daneman A, Woodward S, deSilva M (1978) The radiology of neonatal necrotizing enterocolitis (NEC): a review of 47 cases and the literature. Pediatr Radiol 7: 70CrossRefPubMedGoogle Scholar
  5. 5.
    Kogutt MS (1979) Necrotizing enterocolitis of infancy. Early roentgen patterns as a guide to prompt diagnosis. Radiology 130: 367PubMedGoogle Scholar
  6. 6.
    Siegle RL, Rabinowitz JG, Korones SB, Eyal FG (1976) Early diagnosis of necrotizing enterocolitis. AJR 127: 629PubMedGoogle Scholar
  7. 7.
    Keller MS, Chawla HS (1985) Neonatal metrizamide gastrointestinal series in suspected necrotizing enterocolitis. Am J Dis Child 139: 713PubMedGoogle Scholar
  8. 8.
    Cohen MD, Smith JA, Slabaugh RD, Rust RJ (1982) Neonatal necrotizing enterocolitis shown by oral metrizamide (Amipaque). AJR 138: 1019PubMedGoogle Scholar
  9. 9.
    Leonidas JC, Bhan I, Leape LL (1980) Barium enema in suspected necrotizing enterocolitis: is it ever indicated? Clin Radiol 31: 587CrossRefPubMedGoogle Scholar
  10. 10.
    Negrette J, Ziervogel A, Young DG, Azmy AF (1986) Barium enema examination in neonates with suspected necrotising enterocolitis. Z Kinderchir 41: 19PubMedGoogle Scholar
  11. 11.
    Frey EE, Smith WL, Franken EA Jr, Wintermeyer KA (1986) Analysis of Bowel perforation in necrotizing enterocolitis. Presented at the American Roentgen Ray Society April. Submitted to Pediatric Radiology.Google Scholar

Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • P. Uken
    • 2
  • W. Smith
    • 2
  • E. A. Franken
    • 2
  • E. Frey
    • 2
  • Y. Sato
    • 2
  • C. Ellerbroek
    • 1
  1. 1.Department of RadiologyIowa Methodist HospitalsDes MoinesUSA
  2. 2.Department of Radiology, C 74 OGHUniversity of Iowa Hospital and ClinicsIowa CityUSA

Personalised recommendations