Efficacy of bowel ultrasound to diagnose necrotizing enterocolitis in extremely low birthweight infants.

BACKGROUND: Bowel ultrasound (US) is one of the methods used to enhance diagnostic accuracy of necrotizing enterocolitis (NEC) and its associated complications in premature newborns. AIM: To explore the diagnostic accuracy of BUS in extremely low birth weight (ELBW) infants with NEC. METHODS: A single-center retrospective case-control study included 84 extremely low birth weight (ELBW) infants. The infants were divided into three groups: Group 1 -infants with NEC (n = 26); Group 2 -infants with feeding problems (n = 28); Group 3 -control group (n = 30). RESULTS: The specific BUS findings in premature newborns with NEC (stage 3) included bowel wall thinning, complex (echogenic) ascites, and pneumoperitoneum, p <  0.05. The diagnostic effectiveness of these sonographic signs was 96.8% (sensitivity 75.0% and specificity 97.6%), p <  0.05. These findings with high specificity were associated with the need for surgical intervention, poor outcomes, or increased mortality. Stage 2 NEC which did not require surgery showed impaired differentiation of the bowel wall layers, absent or decreased bowel peristalsis, pneumatosis intestinalis, portal venous gas, or simple ascites, with a diagnostic accuracy of 82.9% (sensitivity 55.6%, specificity 91.4%, p <  0.05). CONCLUSIONS: BUS can be used as an adjunct to abdominal radiography to aid in the diagnosis of infants with suspected NEC by providing more detailed evaluation of the intestine.

THE FUNCTIONAL STATE OF THE SMALL INTESTINE IN THE EARLY STAGES OF GALL STONE FORMATION.

Complex studying of functional condition of small intestine at bile stone disease and analyzing connection of small intestine functional disorders with formation of lithogenic bile. 123 patients with Bile stone disease were examined at pre-stone stage. Examinations done include ultrasonic exam of gallbladder, biochemical examination of bile, studying of bile acids in the bile by method of mass-spectrometry, morphological examination of duodenal mucous membrane, functional examination of small intestine with loading test. RESULTS: As the survey showed, a biliary sludge was found at 86,2% of the patients at ultrasonic examination of gallbladder In the patients' bile there were noticed changes of both general pool of bile acids and of ratio of their separate fractions. 82% of patients with bile stone disease at pre-stone stage had disorders of digestive and absorbing functions of small intestine, connected with reducing of general pool of bile acids in bile.