الفهرس 
Title : Role of abdominal ultrasound in diagnosing necrotizing enterocolitis
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Abstract
Background: Necrotizing enterocolitis (NEC) is an inflammatory gastrointestinal disease of unknown etiology that primarily affects the preterm neonate and carries a high mortality rate.
Aim: The aim of this study was to explore whether abdominal ultrasound (AUS) provides additional information over plain radiography in cases of necrotizing enterocolitis (NEC).
Material and methods: This case-control study was conducted in neonatal intensive care unit (NICU) of Cairo University Hospitals, included 90 neonates with suspected or proven NEC during the period from 2018 to 2020. Gestational age, sex, history (prenatal, natal, postnatal), maternal history, general and abdominal examination were recorded. Patients were classified according to Bell’s staging and laboratory findings also were recorded. Erect abdominal X-rays were performed as well as abdominal ultrasound within less than 24 hours of the plain radiography.
Results: The 90 neontes included in this study were divided in 2 equal groups: suspected NEC and proven NEC. In the suspected groups males accounted for 22 out of 45 newborns and in the proven group for 28. According to modified Bell’s staging the suspected group consisted of: 43 newborns (95.6%) with stage 1a and 2 (4.4%) with stage 1b. As for the proven group, 31 (68.9%) had stage 2a, 11 (24.4%) had stage 2b and 3 (6.7%) had stage 3a. There were statistically significant differences between ultrasound (US), and X-ray findings as regards the wall thickness and intramural air. Using X-ray, wall thickness was normal in 71(78.9%), and increased in 19 (21.1%), where by US wall thickness was normal in 50(55.6%), thick in 25(27.8%) and thin in 15 (16.7%). Moreover intramural air was present in only 18 neonates (20.0%) using X-ray but in 39(43.3%) using US. In addition, some important ultrasound findings (portal venous gas in 3 cases (3.3%), free intra-abdominal air in 3 cases (3.3%) and free intra-abdominal fluid in 17 cases (18.9%) ), were only detectable by US. Taking the US findings in consideration would have led to a worser Bell staging in 11 of suspected group