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A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
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Characteristic Radiological findings in Preterm Infants with Missed Intestinal Perforation

Sivasankar Jayakumar1, Nitin Patwardhan1

  • 1Department of Paediatric surgery, University Hospitals of Leicester Infirmary road, Leicester, United Kingdom LE1 5WW.

Journal of Neonatal Surgery
|May 30, 2015
PubMed

Insights

Necrotizing enterocolitis (NEC) can cause intestinal perforation in preterm infants, sometimes missed on X-rays. Characteristic imaging findings may indicate perforation requiring surgical intervention.

Area of Science:

  • Neonatal surgery
  • Pediatric gastroenterology
  • Medical imaging in neonates

Background:

  • Pneumoperitoneum on imaging is typical for intestinal perforation in necrotizing enterocolitis (NEC).
  • However, intestinal perforation can be missed on radiological imaging in some cases.
  • This study presents cases of preterm infants with missed intestinal perforation despite characteristic X-ray findings.

Purpose of the Study:

  • To highlight cases of missed intestinal perforation in preterm infants with necrotizing enterocolitis.
  • To identify characteristic radiological findings that may indicate missed intestinal perforation.
  • To emphasize the importance of surgical intervention in suspected cases.

Main Methods:

  • Retrospective review of neonates with intra-operative diagnosis of intestinal perforation missed on abdominal X-ray.
  • Study period of 6 months.
  • Analysis of clinical presentation, imaging, and surgical outcomes.

Main Results:

  • Three preterm infants (24-30 weeks gestation) with necrotizing enterocolitis were identified.
  • All patients had patent ductus arteriosus (PDA), required ventilator and inotropic support.
  • Repeated X-rays showed localized, fixed gas shadows, prompting surgical exploration revealing small bowel perforation and pseudocysts.

Conclusions:

  • Intestinal perforation in premature infants with NEC can be overlooked on imaging.
  • Characteristic abdominal X-ray findings, such as localized fixed gas shadows, should prompt surgical evaluation.
  • Early surgical intervention is crucial for managing missed intestinal perforations in NEC.
Abstract

Keywords:
Missed intestinal perforationNecrotizing enterocolitisNeonatePretermPseudocyst

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