TY - JOUR T1 - Correlation between pneumoperitoneum and surgical findings and morbidity and mortality in newborns with necrotising enterocolitis JO - Anales de Pediatría (English Edition) T2 - AU - Villamil,Vanesa AU - Fernández-Ibieta,María AU - Gilabert Ubeda,María Amparo AU - Aranda García,María Josefa AU - Ruiz Pruneda,Ramón AU - Sánchez Morote,Juana María AU - Ruiz Jiménez,José Ignacio SN - 23412879 M3 - 10.1016/j.anpede.2018.08.002 DO - 10.1016/j.anpede.2018.08.002 UR - https://analesdepediatria.org/en-correlation-between-pneumoperitoneum-surgical-findings-articulo-S2341287918301509 AB - IntroductionSurgical intervention in necrotising enterocolitis (NEC) is correct when there is intestinal gangrene. This is evident when gangrene produces perforation and pneumoperitoneum, with this being the only universally accepted radiological indication for the surgical intervention of NEC. ObjectiveTo perform an analysis on patients with surgically managed NEC, including determining how the decision to intervene is reached, the outcomes, and if patients with perforation had a pneumoperitoneum. MethodsRetrospective review of neonates with surgical NEC over a period of 10years (2006–2015). An analysis was made of pre-surgical X-ray findings, which were compared with surgical ones, in addition to the morbidity and mortality, depending on the presence (N+) or absence (N−) of pneumoperitoneum. An evaluation was also made of the interobserver concordance with a paediatric radiologist blinded to the clinical reason using the kappa agreement index. ResultsA total of 53 neonates were included in the study. Surgical treatment was indicated after observing pneumoperitoneum in 36%. In the remaining neonates, the surgical decision was made after noting a clinical and metabolic deterioration with classical X-ray findings. Intestinal perforation was observed in 39% of the N− neonates.There were no statistical differences between either group on analysing the excised intestinal length, days of intubation, starting of enteral nutrition, and the mortality rate. Comparisons in terms of duration of symptoms and total hospital stay were statistically significant (7 vs. 2 days, p=0.008; 127 vs. 79 days, p=0.003, respectively), with both being more favourable in the N+ group. These differences remained when the groups were adjusted by birthweight. ConclusionsSurgical indication has to be done on an ensemble of clinical and radiological evidence, as 39% of the neonates in the N− groups were perforated.In our study, the presence of a pneumoperitoneum did not correlate with a worse prognosis. ER -