Ultrasound to diagnose spontaneous intestinal perforation in infants weighing ⩽1000 g at birth

Objective:to evaluate the usefulness of abdominal ultrasound in infants with gasless abdomen radiographically suspected to have spontaneous intestinal perforation (sip).study design:this was a retrospective analysis of data from our neonatal database including infants with birth weight ⩽1000 g with suspicion of sip, for the period january 2000 to may 2012.result:four hundred and ninety-six infants weighing ⩽1000 g were identified. there were 68 infants with suspicion for sip, 11 with pneumoperitoneum and 57 with gasless abdomen on x-rays. ultrasound was performed in 55 of 57 infants with gasless abdomen, 10 with sip and 45 nonperforated. echogenic free fluid (eff) was present in 70% of patients with sip and 11% of nonperforated patients (p<0.001). when performed within 2 days of surgical diagnosis, eff had 100% sensitivity and 89% specificity, with 58% positive predictive value and 100% negative predictive value.conclusion:these data suggest that abdominal ultrasound may be useful for the diagnosis of sip in infants with birth weight ⩽1000 g presenting with gasless abdomen.