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Ultrasound to diagnose spontaneous intestinal perforation in infants weighing ⩽1000 g at birth

Journal of Perinatology volume 35, pages 104–109 (2015)Cite this article

Subjects

Abstract

Objective:

To evaluate the usefulness of abdominal ultrasound in infants with gasless abdomen radiographically suspected to have spontaneous intestinal perforation (SIP).

Study Design:

This was a retrospective analysis of data from our neonatal database including infants with birth weight ⩽1000 g with suspicion of SIP, for the period January 2000 to May 2012.

Result:

Four hundred and ninety-six infants weighing ⩽1000 g were identified. There were 68 infants with suspicion for SIP, 11 with pneumoperitoneum and 57 with gasless abdomen on X-rays. Ultrasound was performed in 55 of 57 infants with gasless abdomen, 10 with SIP and 45 nonperforated. Echogenic free fluid (EFF) was present in 70% of patients with SIP and 11% of nonperforated patients (P<0.001). When performed within 2 days of surgical diagnosis, EFF had 100% sensitivity and 89% specificity, with 58% positive predictive value and 100% negative predictive value.

Conclusion:

These data suggest that abdominal ultrasound may be useful for the diagnosis of SIP in infants with birth weight ⩽1000 g presenting with gasless abdomen.

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Acknowledgements

We thank the neonatologists, neonatal fellows and the staff of our NICU for their cooperation with the study. We also thank Dr Lorayne Barton for her assistance in navigating the database system.

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Authors and Affiliations

  1. USC Division of Neonatal Medicine, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    A Fischer, M Durand & R G Cayabyab

  2. Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    A Fischer, M Durand & R G Cayabyab

  3. Department of Radiology, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    L Vachon

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  1. A Fischer
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  2. L Vachon
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Correspondence to R G Cayabyab.

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The authors declare no conflict of interest.

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Fischer, A., Vachon, L., Durand, M. et al. Ultrasound to diagnose spontaneous intestinal perforation in infants weighing ⩽1000 g at birth. J Perinatol 35, 104–109 (2015). https://doi.org/10.1038/jp.2014.169

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