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Implementation of bowel ultrasound practice for the diagnosis and management of necrotising enterocolitis
  1. Karen M Alexander1,2,
  2. Sherwin S Chan2,
  3. Erin Opfer2,
  4. Alain Cuna3,
  5. Jason D Fraser3,
  6. Shazia Sharif4,
  7. Minesh Khashu5,6
  1. 1 GME Radiology, University of Missouri Kansas City, Kansas City, Missouri, USA
  2. 2 Department of Radiology, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA
  3. 3 Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA
  4. 4 Department of Paediatric Surgery, Royal London Hospital, London, UK
  5. 5 Neonatal Service, Poole Hospital NHS Foundation Trust, Poole, UK
  6. 6 Bournemouth University, Poole, UK
  1. Correspondence to Dr Minesh Khashu, Neonatology, Poole Hospital NHS Foundation Trust, Poole, UK; minesh.khashu{at}


Necrotising enterocolitis (NEC) is a serious inflammatory bowel disease of prematurity with potentially devastating complications and remains a leading cause of morbidity and mortality among premature infants. In recent years, there has been accumulating data regarding benefits of using bowel ultrasound (BUS) in the diagnosis and management of NEC. Despite this, adoption of robust BUS programmes into clinical practice has been slow. As BUS is a relatively new technique, many barriers to implementation exist, namely lack of education and training for sonographers and radiologists, low case volume and unfamiliarity by clinicians regarding how to use the information provided. The aim of this manuscript is to provide a framework and a roadmap for units to implement BUS in day-to-day practice for NEC diagnosis and management.

  • paediatric surgery
  • gastroenterology
  • imaging
  • intensive care
  • multidisciplinary team-care

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  • Contributors KMA: writing, submitting author and no disclosures. SSC: advising, editing, images and imaging knowledge. EO: writing, editing, images, imaging knowledge and advising. AC: neonatology clinical knowledge, clinical questions writing and editing. JDF and SS: paediatric surgery knowledge and editing. MK: corresponding author, conceptualised manuscript, advising, editing, neonatology clinical knowledge and insights.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests SSC reports grants and personal fees from Jazz pharmaceuticals, outside the submitted work.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data sharing is not applicable as no datasets are generated and/or analysed for this study. Not applicable.

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