title: Ultrasound to diagnose spontaneous intestinal perforation in infants weighing ⩽ 1000 g at birth.
abstract: OBJECTIVE
  To evaluate the usefulness of abdominal ultrasound in infants with gasless abdomen radiographically suspected to have spontaneous intestinal perforation (SIP).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1] USC Division of Neonatal Medicine, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA [2] Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Fischer
authors.affiliation: Department of Radiology, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Vachon
authors.affiliation: 1] USC Division of Neonatal Medicine, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA [2] Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Durand
authors.affiliation: 1] USC Division of Neonatal Medicine, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA [2] Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: R G
authors.initials: RG
authors.lastname: Cayabyab
mesh_terms: D034841:Abdominal Cavity / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000502:physiology; D007231:Infant, Newborn; D007416:Intestinal Perforation / Q000000981:diagnostic imaging*; D008297:Male; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods / Q000706:statistics & numerical data; D014481:United States