Current prognosis in necrotizing enterocolitis with portal vein gas.
OBJECTIVE
To investigate anecdotal reports that portal vein gas in necrotizing enterocolitis is no longer associated with a poor prognosis.


METHODS
Twelve cases of neonatal necrotizing enterocolitis with portal vein gas from 1988 to 1994 were identified retrospectively from the radiology dictation system in a large university hospital.


RESULTS
Two distinct groups of patients with portal vein gas in necrotizing enterocolitis were identified. In 3 of the 12 children, portal vein gas was identified on abdominal films after the diagnosis of necrotizing enterocolitis. These infants had no serious sequelae. By contrast, in 8 of the 9 infants with portal vein gas seen on the initial film at presentation, emergent surgery was required. Four of these infants died from complications of necrotizing enterocolitis and 2 died from sepsis related to total parenteral nutrition. The remaining 2 children have short bowel syndrome, 1 is dependent on total parenteral nutrition and 1 requires continuous gastrostomy tube feedings.


CONCLUSIONS
The children with portal vein gas on the initial abdominal film continue to have a guarded prognosis.
Department of Pediatrics, University of Michigan Hospitals, Ann Arbor 48109, USA.
A J
AJ
Ping
C E
CE
Blane
K A
KA
Garver
D004761:Enterocolitis, Pseudomembranous / Q000000981:diagnostic imaging*; D005260:Female; D005740:Gases; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011379:Prognosis; D011860:Radiography, Abdominal; D012189:Retrospective Studies
D005740:Gases