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previously visited 080729 NECROTIZING ENTEROCOLITIS Random Case
Authored By: pedrad CSH, Radiologist, Chung Shan Medical University Hospital, Taiwan.
Patient: 2 week old male
History:

Chief complain: Abdominal distention 2+weeks after bith

Caesarean section with gestational age 32+ 6/7 weeks.
Birthbody weight: 2000gm. G1P1A0, Twin B
Apgar score: 5 (at 1st min) to 6 (at 5th min).
Smooth prenatal course.

Images:small[medium]largeas-submittedimages only

Fig. 1: Photo

Fig. 2: KUB

Fig. 3: KUB

Fig. 4: KUB

Fig. 5: Surgery

Fig. 6: Surgery

Fig. 7: Surgery
Images:small[medium]largeas-submittedimages only
Findings:

Photo:
Abdominal distention with ecchymosis

KUB:
1. Bowel loops air-filled dilatation with air bubbles in theirs
   walls (arrows in figure 3), in favor of pneumatosis intestinalis.
2. Diffuse linear lucencies in liver, suggesting gas in
   portal vein (pneumoportal, arrows in figure 4).
3. From above findings, necrotizing enterocolitis should be
   considered until proved otherwise.

Surgery:
Diffuse ischemic change of bowel.
Air bubbles in bowel wall (arrow in figure 7).
No bowel resection because of too large range of bowel segment involvement.

Diagnosis: Necrotizing enterocolitis
(Bile culture: Escherichia coli)
Comments: post a comment
Great images! Great description of the findings! --Nils Hoyer, 2009-03-02 08:42:51
What was the outcome of this case? The correlations between radiological findings and anatomo-pathological images are brilliant!--irina Besu, 2009-03-05 06:52:03
< Note > There was no bowel resection during operation because of too large range of bowel segment involvement. Thus, only a peritoneal drainage tube was inserted for post-operation normal saline irrigation. The patient expired on the next day of surgery, unfortunately. by Dr. Tsao--pedrad CSH, 2009-03-05 20:51:48
Additional Details:

Case Number: 18921123Last Updated: 09-08-2008
Rating:

2 ratings
Anatomy: Gastrointestinal (GI)   Pathology: Infection
Modality: Conventional Radiograph, PhotographAccess Level: Readable by all users
Keywords: necrotizing enterocolitis, pneumatosis intestinalis, pneumoportal, gas, airACR: 78.782Contained in: ahmeeed, brigrissom
Case has been viewed 786 times.

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