Approximately 4000 newborns (NB) per year develop NEC in USA and 30-50% of them die. Clinical, radiological and laboratory findings of advanced NEC are well known, but signs in early disease are less specific and sensitive, making early diagnosis of this condition elusive. Therefore, many NB are diagnosed late, with serious consequences. Many others are treated unnecessarily for long periods of time because of “suspected” but never proven NEC. Iphexol (Omnipaque®), an iodine containing an inert substance poorly absorbed by normal Gl, is highly absorbed in an animal model with ischemic bowel disease. NEC alters absorptive characteristics of the Gl tract in NB but no studies with IOH have been performed. Differences in systemic Gl absorption of IOH may be of value in NB with clinical suspicion of NEC to differentiate those who really have NEC from those who do not. The purpose of this controlled, blind study was to determine if CT scan counts of IOH concentration in urine samples may be a useful test to diagnose NEC early. NB with feeding intolerance and early clinical suspicion of NEC were eligible for the study (Group I). NB who needed a Gl contrast study for other reasons (GE reflux, Gl obstruction, etc.) and never had suspicion of NEC acted as controls(Group II). Exclusion criteria were: definitive evidence of NEC, presence of shock and renal failure. IOH (diluted to 225 mOsm) was given into the stomach at a dose of 8ml/kg when NEC was suspected. Urine was collected for 12 hs in different alliquots. Urine samples were scanned by CT (lmatron Cine Ct Scanner). All X-ray and clinical data were collected prospectively. For infants in Group I, final diagnosis of NEC (“1-NEC”) or of NO NEC(“1-NO NEC”) was established by classic clinical and X-ray criteria. NB were managed by teams unaware of CT counts. The M.D. performing the CT counts was blind to group assignment, X-ray findings and final diagnosis. We report preliminary results for 20 NB, 14 in group 1 (6 in subgroup “1-NEC and 8 in “1-no NEC”) and 6 in group II. No side effects were found. In subgroup “1-NEC” urine CT counts were 71(±12): all infants had a count >50. In subgroup “1-NO NEC” CT counts were 16(±6) and all had counts<30. In group II the counts were 13(±7); all <30. No false positives or negatives have been found so far. If the findings of this pilot study persist, this test may become of great clinical value for early diagnosis of NEC, due to the sensitivity, specificity and predictive values found to date.