A Fischer1, L Vachon2, M Durand1, R G Cayabyab1. 1. 1] USC Division of Neonatal Medicine, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA [2] Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. 2. Department of Radiology, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Abstract
OBJECTIVE: To evaluate the usefulness of abdominal ultrasound in infants with gasless abdomen radiographically suspected to have spontaneous intestinal perforation (SIP). STUDY DESIGN: This was a retrospective analysis of data from our neonatal database including infants with birth weight ⩽ 1000 g with suspicion of SIP, for the period January 2000 to May 2012. RESULT: Four hundred and ninety-six infants weighing ⩽ 1000 g were identified. There were 68 infants with suspicion for SIP, 11 with pneumoperitoneum and 57 with gasless abdomen on X-rays. Ultrasound was performed in 55 of 57 infants with gasless abdomen, 10 with SIP and 45 nonperforated. Echogenic free fluid (EFF) was present in 70% of patients with SIP and 11% of nonperforated patients (P<0.001). When performed within 2 days of surgical diagnosis, EFF had 100% sensitivity and 89% specificity, with 58% positive predictive value and 100% negative predictive value. CONCLUSION: These data suggest that abdominal ultrasound may be useful for the diagnosis of SIP in infants with birth weight ⩽ 1000 g presenting with gasless abdomen.
OBJECTIVE: To evaluate the usefulness of abdominal ultrasound in infants with gasless abdomen radiographically suspected to have spontaneous intestinal perforation (SIP). STUDY DESIGN: This was a retrospective analysis of data from our neonatal database including infants with birth weight ⩽ 1000 g with suspicion of SIP, for the period January 2000 to May 2012. RESULT: Four hundred and ninety-six infants weighing ⩽ 1000 g were identified. There were 68 infants with suspicion for SIP, 11 with pneumoperitoneum and 57 with gasless abdomen on X-rays. Ultrasound was performed in 55 of 57 infants with gasless abdomen, 10 with SIP and 45 nonperforated. Echogenic free fluid (EFF) was present in 70% of patients with SIP and 11% of nonperforated patients (P<0.001). When performed within 2 days of surgical diagnosis, EFF had 100% sensitivity and 89% specificity, with 58% positive predictive value and 100% negative predictive value. CONCLUSION: These data suggest that abdominal ultrasound may be useful for the diagnosis of SIP in infants with birth weight ⩽ 1000 g presenting with gasless abdomen.
Authors: Phillip V Gordon; Andrew C Herman; Marek Marcinkiewicz; Benjamin M Gaston; Victor E Laubach; Judy L Aschner Journal: J Pediatr Gastroenterol Nutr Date: 2007-11 Impact factor: 2.839