importance of portal venous gas in neonatal necrotizing enterocolitis; review of 15 cases

ABSTRACT

To find out if the presence of portal venous gas [PVG] in the abdominal radiography of neonates with necrotizing enterocolitis [NEC] indicates surgical intervention. Retrospective study of cases of NEC managed by the authors over a period of 5 years. Cases with and without PVG were compared Records of 63 neonates with the diagnosis of NEC were obtained. The overall mortality was 20 cases [31.7%]. In both the medically [48 cases] and the surgically [15 cases] treated group. The mortality rates of cases with PVG were not statistically different from those without PVG [33.3% versus 15% ; P value=0.3, for the medical, and 83% versus 66.6% ; P value=0.6, for the surgical]. At surgery, intestinal pan-necrosis was found in 3 cases with PVG [50%] and non in cases without PVG [P=0.04]. Many cases of NEC with PVG could be treated successfully without surgery, with no difference in mortality. However, the presence of this radiological sign in cases requiring surgery, based on other indications, is associated with poor prognosis