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新生儿坏死性小肠结肠炎合并肝脓肿:腹部超声的诊断价值

Necrotizing Enterocolitis Complicated by Hepatic Abscesses in a Neonate: Diagnostic Utility of an Abdominal Ultrasound.

作者信息

Takahishi Kenichi, Kido Takahiro, Okada Yuki, Deguchi Takuma, Nozaki Yoshihiro, Miyazono Yayoi, Takada Hidetoshi

机构信息

Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, JPN.

Department of Child Health, Institute of Medicine, University of Tsukuba, Tsukuba, JPN.

出版信息

Cureus. 2025 Apr 1;17(4):e81587. doi: 10.7759/cureus.81587. eCollection 2025 Apr.

Abstract

We report a case of multiple liver abscesses after necrotizing enterocolitis (NEC), which were successfully detected by ultrasound screening and treated successfully. This baby was not premature but had truncus arteriosus and was at risk of NEC. NEC developed on day 7, and abdominal drainage, bowel resection, and enterostomy were performed on day 12. The postoperative clinical course and laboratory data were uneventful. However, abdominal ultrasound screening, which was performed to check for any postoperative complications, revealed multiple liver abscesses on postoperative day 14. Contrast-enhanced computed tomography was performed at the same time, but only one of them was detected. Broad-spectrum antibiotics were administrated intravenously for eight weeks in total. Follow-up ultrasounds showed only scars by day 79. The prognosis for neonates with multiple liver abscesses after NEC is poor, but they could be detected by ultrasound and successfully treated while asymptomatic in this case. High spatial resolution for small lesions and noninvasiveness to patients make ultrasound suitable for screening neonatal liver abscesses. Neonatal NEC can cause fatal complications. The development of workup protocols, including ultrasound screening, may contribute to improved prognosis.

摘要

我们报告1例坏死性小肠结肠炎(NEC)后发生多发性肝脓肿的病例,该病例经超声筛查成功检出并得到成功治疗。此婴儿并非早产儿,但患有共同动脉干,有发生NEC的风险。NEC于第7天出现,第12天进行了腹腔引流、肠切除和肠造口术。术后临床病程和实验室数据均无异常。然而,为检查术后并发症而进行的腹部超声筛查在术后第14天发现了多发性肝脓肿。同时进行了对比增强计算机断层扫描,但仅检测到其中1个。总共静脉注射广谱抗生素8周。随访超声显示至第79天时仅见瘢痕。NEC后发生多发性肝脓肿的新生儿预后较差,但在此病例中,它们可通过超声检测到,并在无症状时得到成功治疗。超声对小病灶的高空间分辨率及对患者的无创性使其适用于新生儿肝脓肿的筛查。新生儿NEC可导致致命并发症。制定包括超声筛查在内的检查方案可能有助于改善预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ff5/12045754/ff533ca3d847/cureus-0017-00000081587-i01.jpg

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