Value of different radiological examination methods in diagnosis of necrotic enterocolitis in Children’s Clinical University Hospital from 2015 to 2020

Necrotic enterocolitis (NEC is affecting approximately 7% of very preterm infants. Imaging is essential in making NEC diagnosis. Plain abdominal radiography (AR) is the preferred modality and abdominal ultrasonography (AUS) is increasingly helpful in diagnosis of NEC. The blood tests like white blood cell count (WBC) and C-reactive protein (CRP) are not specific but may be used as supportive evidence for diagnosis. Aim was to analyze the count of cases where diagnosis was established based on radiological examinations (RE) and blood inflamatory markers (BIM) like WBC, CRP, IL-6. To evaluate the criteria of diagnosis in CCUH and the treatment (conservative or surgical) that was used. 2455 patient history charts with diagnosis of SSK 10 classifier P77 and P07 was reviewed from 2015 to 2020 to find patients with NEC diagnosis using data storage system Andromeda in CCUH, Riga. Statistical analysis were performed in MS Excel and IBM SPSS. In the time period 2015-2020 110 NEC patients were selected. In 38 (34,6%) cases NEC was confirmed or suspected in AR and in 64 (58,1%) cases – in AUS. In 25 (22,7%) NEC was confirmed in both examinations. In 26 (23,6%) no NEC signs in any RE. In reviewed data NEC stage was mentioned extremely rarely. 63 (54,5%) cases had NEC signs in one or both RE and one/both BIM were elevated. 41 (37,4%) had positive RE finding or elevated one/both BIM. In 3 (2,7%) cases RE and BIM were negative. 20 (18%) patients were treated surgically. In 15 (75%) patients, who were operated on, had positive one/both RE and 4 (20%) had negative RE but positive BIM. 1. Frequently the criteria and staging of NEC diagnosis weren’t clear. 2. According to our data higher diagnostic value showed AUS. 3. A common NEC diagnostic algorithm would be a useful tool in CCUH.