{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:26:23Z","timestamp":1756383983574,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,9,14]]},"abstract":"<jats:p>A female preterm infant was born to a non-consanguineous couple at 35\u2005weeks of gestation. On day 8 of life, while on full feeds, she developed prolonged apnoea and bradycardia, requiring respiratory support. Her abdomen was soft with unremarkable serial abdominal X-rays. Her septic screen was negative. Metabolic acidosis was worsening despite treatment. Echocardiography showed evidence of high pulmonary pressures. With further deterioration, an ultrasound scan of the abdomen was requested in view of the rising suspicion of abdominal pathology in the absence of sepsis and metabolic disorders. Mural oedema, pneumatosis and portal venous gas, consistent with diagnosis of necrotising enterocolitis, were noted in the ultrasound images. An emergency laparotomy showed extensive small bowel necrosis. Despite maximal medical support, the infant died. This case highlights the importance of imaging using an ultrasound scanner in the diagnosis of necrotising enterocolitis in preterm infants having intractable metabolic acidosis, subtle abdominal signs and unremarkable abdominal X-rays.<\/jats:p>","DOI":"10.1136\/bcr-2016-216756","type":"journal-article","created":{"date-parts":[[2016,9,28]],"date-time":"2016-09-28T11:29:51Z","timestamp":1475062191000},"page":"bcr2016216756","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Atypical presentation of acute fulminant neonatal necrotising enterocolitis: diagnostic superiority of sonographic evaluation over plain radiography of abdomen"],"prefix":"10.1136","volume":"2016","author":[{"given":"Vidya","family":"Ramasamy","sequence":"first","affiliation":[{"name":"Department of Neonatology, KK Women's and Children's Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harvey","family":"Teo","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional imaging, KK Hospital, Singapore"},{"name":"Duke-NUS Medical School, Singapore"},{"name":"Yong Loo Lin School of Medicine, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor Samuel","family":"Rajadurai","sequence":"additional","affiliation":[{"name":"Department of Neonatology, KK Women's and Children's Hospital, Singapore"},{"name":"Duke-NUS Medical School, Singapore"},{"name":"Yong Loo Lin School of Medicine, Singapore"},{"name":"Lee Kong Chian School of Medicine, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresh","family":"Chandran","sequence":"additional","affiliation":[{"name":"Department of Neonatology, KK Women's and Children's Hospital, Singapore"},{"name":"Duke-NUS Medical School, Singapore"},{"name":"Yong Loo Lin School of Medicine, Singapore"},{"name":"Lee Kong Chian School of Medicine, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,9,28]]},"reference":[{"key":"2025082802382964000_2016.sep28_1.bcr2016216756.1","doi-asserted-by":"crossref","first-page":"328","DOI":"10.47102\/annals-acadmedsg.V42N7p328","article-title":"Borderline viability\u2014neonatal outcomes of infants in Singapore over a period of 18 years (1990\u20132007)","volume":"42","author":"Agarwal","year":"2013","journal-title":"Ann Acad Med Singap"},{"key":"2025082802382964000_2016.sep28_1.bcr2016216756.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-005-1533-4"},{"key":"2025082802382964000_2016.sep28_1.bcr2016216756.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-006-0393-x"},{"key":"2025082802382964000_2016.sep28_1.bcr2016216756.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-010-2737-8"},{"key":"2025082802382964000_2016.sep28_1.bcr2016216756.5","doi-asserted-by":"publisher","DOI":"10.1148\/rg.272055098"},{"key":"2025082802382964000_2016.sep28_1.bcr2016216756.6","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2012-302848"},{"key":"2025082802382964000_2016.sep28_1.bcr2016216756.7","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2007.132019"},{"key":"2025082802382964000_2016.sep28_1.bcr2016216756.8","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1265204"},{"key":"2025082802382964000_2016.sep28_1.bcr2016216756.9","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-013-2725-y"},{"key":"2025082802382964000_2016.sep28_1.bcr2016216756.10","first-page":"1","article-title":"Usefulness of ultrasound examinations in the diagnostics of necrotizing enterocolitis","volume":"80","author":"Staryszak","year":"2015","journal-title":"Pol J Radiol"},{"key":"2025082802382964000_2016.sep28_1.bcr2016216756.11","doi-asserted-by":"crossref","first-page":"531","DOI":"10.7863\/jum.1993.12.9.531","article-title":"Use of ultrasound in the detection of occult bowel perforation in neonates","volume":"12","author":"Miller","year":"1993","journal-title":"J Ultrasound Med"},{"key":"2025082802382964000_2016.sep28_1.bcr2016216756.12","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-014-3613-8"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-216756","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:38:38Z","timestamp":1756373918000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-216756"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9,28]]},"references-count":12,"alternative-id":["10.1136\/bcr-2016-216756"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-216756","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2016,9,28]]}}}