Assessing the Efficacy of A Scoring System in Surgical NEC Diagnosis

zObjective: To evaluate the efficacy of the necrotizing enterocolitis-treatment-aid (NEC-T-Aid) tool for diagnosing perforated NEC in preterm infants, particularly in cases in which pneumoperitoneum is absent.Methods: This retrospective study included patients with surgically confirmed perforated NEC at a single-center from 2012 to 2022.Patients were assessed using the NEC-T-Aid assessment tool, which includes the clinical, abdominal signs, serological markers, and X-ray findings.Patients without pneumoperitoneum were specifically analyzed to determine the tool's diagnostic accuracy.Results: Among the 39 patients included in the study, 25% of those with perforated NEC without pneumoperitoneum could not be definitively diagnosed using the NEC-T-Aid tool.Patients in the pneumoperitoneum group also experienced longer delays from initial evaluation to surgery, more extensive bowel resections, and a higher incidence of pediatric intestinal failure compared with patients in the pneumoperitoneum group. Conclusion:The NEC-T-Aid tool has limitations in diagnosing perforated NEC in patients lacking pneumoperitoneum, highlighting the need for enhanced diagnostic methods.Improving early detection and intervention strategies are crucial for better managing NEC and reducing complications, such as extensive bowel resection and pediatric intestinal failure.