CC-BY 4.0 · European J Pediatr Surg Rep 2017; 05(01): e43-e46
DOI: 10.1055/s-0037-1606196
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Laser Speckle Contrast Imaging to Evaluate Bowel Lesions in Neonates with NEC

Kristine Bach Korsholm Knudsen
Department of Surgical Gastroenterology and Pediatric Surgery, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
,
Joergen Thorup
Department of Surgical Gastroenterology and Pediatric Surgery, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
,
Rune Broni Strandby
Department of Surgical Gastroenterology and Pediatric Surgery, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
,
Rikard Ambrus
Department of Surgical Gastroenterology and Pediatric Surgery, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
,
Linea Landgrebe Ring
Department of Surgical Gastroenterology and Pediatric Surgery, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
,
Inge Ifaoui
Department of Surgical Gastroenterology and Pediatric Surgery, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
› Author Affiliations
Further Information

Publication History

20 April 2017

16 July 2017

Publication Date:
31 August 2017 (online)

Abstract

Background Necrotizing enterocolitis (NEC) is the most frequent surgical emergency in newborns. Intestinal ischemia is considered a factor that precedes the development of NEC lesions. Laser speckle contrast imaging (LSCI) can be used to assess tissue microcirculation. We evaluated if LSCI may help to detect intestinal regions with reduced microcirculation in NEC.

Case Report A male patient (gestational age, 26 [3/7] weeks; birth weight, 600 g) showed clinical signs of NEC 28 days after birth. X-ray revealed pneumatosis intestinalis and portal gas. Laparotomy showed NEC lesions with signs of transmural ischemia in the terminal ileum and cecum. Surgical resection lines (RLs) were marked, followed by LSCI measurements and resection of the bowel between the two RLs. Post hoc LSCI analyses were conducted on both sides of the proximal and distal RL. Low-flux values, indicating reduced microcirculation, were found in the macroscopically assessed necrotic bowel at the proximal RL, whereas higher flux values, indicating sufficient microcirculation, were found in the macroscopically assessed normal bowel.

Discussion This study is the first description of intra-abdominal use of LSCI to evaluate tissue microcirculation in relation to NEC lesions. LSCI could be a valuable tool to distinguish between ischemic and nonischemic bowel in neonates undergoing surgery for NEC.