The role of abdominal ultrasound in surgical decision making for necrotizing enterocolitis

Despite advances in neonatal care, Necrotizing enterocolitis (NEC) remains one of the most devastating gastrointestinal complications affecting most often preterm infants and full -term infants with congenital heart disease. Early and accurate diagnosis is vital to reduce morbidity and mortality. While abdominal radiography has traditionally served as the cornerstone of diagnosis, abdominal ultrasound (AUS) emerges as an additional tool offering the benefits of a real-time, radiation-free and functional assessment of the bowel. However, the role of AUS in the assessment of need for surgery remains less clear. This commentary addresses some of the available observational studies and existing evidence on the role of AUS for the diagnosis of NEC and the challenges associated with implementation of this practice, and the lack of well-designed prospective trials.