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Systemic arterial pneumatosis in a neonate with necrotizing enterocolitis
Stuart C Morrison1, Janet R Reid, Mark Harrison
1Division of Radiology, Cleveland Clinic Children's Hospital, Hb6, 9500 Euclid Avenue, Cleveland, OH 44195, USA. morriss@ccf.org
Pediatric Radiology
|November 19, 2003
Summary
Ultrasound identified systemic arterial pneumatosis in a neonate with necrotizing enterocolitis and congenital heart disease. This rare finding suggests a pathway from the portal vein to the aorta via cardiac shunts.
Area of Science:
- Neonatal imaging
- Pediatric cardiology
- Gastroenterology
Background:
- Necrotizing enterocolitis (NEC) is a common neonatal emergency.
- Portal vein pneumatosis is a hallmark ultrasound finding in NEC.
- Congenital heart disease (CHD) can complicate neonatal presentations.
Observation:
- A neonate with NEC and CHD presented with unusual ultrasound findings.
- Systemic arterial pneumatosis, not typically associated with NEC, was observed.
- The pneumatosis appeared to originate from the portal vein system.
Findings:
- Ultrasound revealed portal vein pneumatosis and systemic arterial pneumatosis.
- A patent ductus venosus and patent ductus arteriosus facilitated extracardiac shunting.
- This anatomical configuration provided a pathway for gas from the portal vein to the aorta.
Implications:
- This case highlights a rare pathway for gas embolism in neonates with NEC and CHD.
- It underscores the importance of comprehensive ultrasound evaluation in complex neonatal cases.
- Understanding these shunts is critical for accurate diagnosis and management of neonatal emergencies.