What is the significance of a finding on abdominal radiography of ascites in the evaluation for necrotizing enterocolitis (NEC)?

Updated: Dec 27, 2017
  • Author: Shelley C Springer, JD, MD, MSc, MBA, FAAP; Chief Editor: Muhammad Aslam, MD  more...
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Intraperitoneal free fluid is indicated by a generalized opacification of the abdomen and often by a gasless abdomen or medial displacement of bowel loops with opacification peripherally and increased distance between bowel loops. The finding of ascites may indicate intestinal fluid leakage from perforation and is an indication for paracentesis.

Ascites is a late finding that usually develops when peritonitis is present or after bowel perforation. Ascites is observed on an AP radiograph as centralized bowel loops that appear to be floating on a background of density. It is better appreciated on ultrasonography.

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