Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Introduction: Despite recent advances in neonatology, necrotizing enterocolitis (NEC) is still a common and devastating gastrointestinal emergency that primarily afflicts premature newborns. The diagnosis of NEC is usually suspected clinically but often requires the aid of diagnostic radiologic modality. Although the precise etiology of NEC is unknown, it is generally accepted that the most important etiologic factor is intestinal ischemia or hypoperfusion leading to altered mucosal integrity. Objectives: Our aims was to assess the splanchnic circulation by measuring mesenteric and celiac arterial blood velocity using duplex ultrasound in patients with neonatal sepsis and to evaluate the presence of radiologic findings for the early diagnosis of NEC in patients with neonatal sepsis using ultrasonography Patients and methods: This is cross-sectional study included 51 neonates less than 37 weeks gestational age, with neonatal sepsis, 25 neonates with feeding intolerance, 26 without, all of them were subjected to clinical examination, laboratory investigations (CBC, CRP, ABG, Na, PT, PC. INR & blood culture) and radiological investigation (abdominal X-ray, abdominal ultrasound & doppler on CA & SMA). Results: In neonates with NEC or symptoms suggesting NEC, abdominal X-ray showed one patient with pneumo-peritoneum, three patients with thickened intestinal wall, while abdominal ultrasound revealed intestinal wall thickening in three patients and free fluid in abdomen in one patient. Peak systolic velocity (PSV) ratio between Celiac Artery: Superior Mesenteric Artery was increased in 16 patients using Doppler study

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