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

TL;DR

A neonate with necrotizing enterocolitis developed multiple liver abscesses detected by abdominal ultrasound, leading to successful treatment.

Contribution

Demonstrates the diagnostic utility of abdominal ultrasound in detecting asymptomatic liver abscesses in neonates with NEC.

Findings

Abdominal ultrasound successfully identified multiple liver abscesses in a neonate post-NEC surgery.

Contrast-enhanced CT detected only one abscess, highlighting ultrasound's superior sensitivity for small lesions.

Early detection and treatment led to a favorable prognosis despite the typically poor outlook for such cases.

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.

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