Neonatologist-performed point-of-care abdominal ultrasound: What have we learned so far?

Archana Priyadarshi; Sheryl Rogerson; Rommel Cruzado; Amanda Crow; Murray Hinder; Himanshu Popat; Soundappan S V Soundappan; Nadia Badawi; Mark Tracy

doi:10.3389/fped.2023.1173311

Neonatologist-performed point-of-care abdominal ultrasound: What have we learned so far?

Front Pediatr. 2023 Apr 28:11:1173311. doi: 10.3389/fped.2023.1173311. eCollection 2023.

Authors

Archana Priyadarshi^{1

2

3}, Sheryl Rogerson⁴, Rommel Cruzado⁵, Amanda Crow⁵, Murray Hinder^{1

3}, Himanshu Popat^{2

3}, Soundappan S V Soundappan^{3

6}, Nadia Badawi^{2

3}, Mark Tracy^{1

3}

Affiliations

¹ Westmead Hospital Neonatal Intensive Care Unit, Sydney, NSW, Australia.
² Grace Centre for Newborn Intensive Care at The Children`s Hospital Westmead, Sydney, NSW, Australia.
³ The University of Sydney, Sydney, NSW, Australia.
⁴ The Royal Women's Hospital Neonatal Intensive Care Unit, Melbourne, VIC, Australia.
⁵ Department of Radiology, The Children's Hospital Westmead, NSW, Australia.
⁶ Department of Surgery, The Children's Hospital Westmead, NSW, Australia.

Abstract

This review describes the sonographic appearances of the neonatal bowel in Necrotising enterocolitis. It compares these findings to those seen in midgut-Volvulus, obstructive intestinal conditions such as milk-curd obstruction, and slow gut motility in preterm infants on continuous positive airway pressure (CPAP)-CPAP belly syndrome. Point-of-care bowel ultrasound is also helpful in ruling out severe and active intestinal conditions, reassuring clinicians when the diagnosis is unclear in a non-specific clinical presentation where NEC cannot be excluded. As NEC is a severe disease, it is often over-diagnosed, mainly due to a lack of reliable biomarkers and clinical presentation similar to sepsis in neonates. Thus, the assessment of the bowel in real-time would allow clinicians to determine the timing of re-initiation of feeds and would also be reassuring based on specific typical bowel characteristics visualised on the ultrasound.

Keywords: NEC=necrotizing enterocolitis; bowel; neonates; ultrasound; vovulus.

Publication types

Review