Barium enema in suspected necrotising enterocolitis: is it ever indicated?

Area of Science:

• Pediatric Gastroenterology
• Diagnostic Imaging
• Neonatal Medicine

Background:

• Necrotising enterocolitis (NEC) is a serious condition in infants requiring accurate and timely diagnosis.
• Early or mild forms of NEC can present diagnostic challenges, potentially delaying appropriate treatment.
• Contrast medium enemas are an established imaging technique, but their role in early NEC diagnosis needs evaluation.

Purpose of the Study:

• To evaluate the diagnostic utility of contrast medium enemas in infants with suspected necrotising enterocolitis (NEC).
• To assess the safety and potential findings of early contrast enemas in the course of NEC.
• To determine if this imaging modality can aid in differentiating NEC from other conditions presenting similar symptoms.

Main Methods:

• Three infants with suspected and confirmed necrotising enterocolitis (NEC) underwent contrast medium enemas.
• The procedure was performed early in the disease course to assist in diagnosis.
• Adverse effects and specific radiological findings were meticulously documented.

Main Results:

• No adverse effects were observed in any of the infants following the contrast enema procedure.
• Radiological findings included persistent spasm in segments of the colon and contour irregularities, suggestive of superficial mucosal ulceration.
• These findings were consistent with early or mild forms of NEC.

Conclusions:

• Carefully performed contrast medium enemas may be a valuable diagnostic tool for early or mild cases of NEC presenting diagnostic difficulties.
• The absence of deep transmucosal necrosis in these early stages significantly reduces the risk of gastrointestinal perforation during the enema examination.
• Contrast enemas can provide crucial information for the management of infants with suspected NEC.