Barium enema in suspected necrotising enterocolitis: is it ever indicated?

Three infants with suspected, and subsequently proven, necrotising enterocolitis (NEC) had contrast medium enemas early in the course of their disease to assist diagnosis. There were no adverse effects from the enemas. All patients had evidence of persistent spasm of segments of the colon and contour speculation, probably representing superficial mucosal ulceration. It is suggested that when early or mild forms of NEC present diagnostic problems, a carefully performed contrast enema may be of diagnostic value. Absence of deep transmucosal necrosis in such cases definitely decreases the risk of perforation during the examination.