Soni Roopali, Katana Anastasia, Curry Joe I, Humphries Paul D, Huertas-Ceballos Angela
Department of Neonatology, University College London Hospital, London, UK.
Department of Paediatric Surgery, Great Ormond Street Hospital, London, UK.
Arch Dis Child Educ Pract Ed. 2020 Feb;105(1):50-57. doi: 10.1136/archdischild-2018-315252. Epub 2019 Feb 18.
Necrotising enterocolitis (NEC) in preterm babies is a serious gastrointestinal emergency with potentially devastating consequences. Prompt and accurate diagnosis continues to be a challenge for health professionals. Early identification of clinical warning signs is extremely important, but the diagnosis relies heavily on the interpretation of abdominal radiographs. Postgraduate training of paediatricians and neonatologists in neonatal abdominal radiography is scarce, and there is variability of radiological input to neonatal services. Lack of a standardised approach and descriptive terminology for interpretation may result in inadequate communication between clinical and surgical teams, inaccurate diagnosis, inappropriate treatment, and unnecessary cessation of feeds and transfers to surgical units. This paper offers a guide designed for the doctor who on a busy night shift needs to interpret an abdominal radiograph and decide on a differential diagnosis of NEC in a preterm baby. It helps to provide structure and standardisation to interpretation of radiological signs using a comprehensive but simple method to support the clinical diagnosis. Our aim is to enhance the correct diagnosis of NEC.
早产儿坏死性小肠结肠炎（NEC）是一种严重的胃肠道急症，可能产生毁灭性后果。对医护人员来说，及时、准确的诊断仍是一项挑战。早期识别临床警示信号极为重要，但诊断很大程度上依赖于对腹部X光片的解读。儿科医生和新生儿科医生在新生儿腹部X光摄影方面的研究生培训稀缺，且新生儿服务的放射学投入存在差异。缺乏标准化的解读方法和描述性术语可能导致临床和外科团队之间沟通不足、诊断不准确、治疗不当以及不必要的停止喂食和转至外科病房。本文为在繁忙夜班需要解读腹部X光片并对早产儿NEC进行鉴别诊断的医生提供了一份指南。它有助于使用一种全面但简单的方法为放射学征象的解读提供结构和标准化，以支持临床诊断。我们的目标是提高NEC的正确诊断率。
