Case Notes
History
A 57 day-old premature infant with the sign of abdominal distention and the history of NEC.Exam
FLUORO GI LOWER CONTRAST ENEMA. An 8 French straight catheter was inserted just into the rectum. Under fluoroscopic guidance, the rectum and descending colon were filled with water-soluble contrast in with 25 mL of contrast, and fluoroscopic images were obtained. The patient was able to expel the catheter and the contrast in the colon on two occasions. On the third catheterization, the transverse colon was reached without resistance. There were no strictures. Injection of contrast was resumed under fluoroscopic guidance and an additional 20 mL was injected. There was no resistance to colon filling. When the contrast reached the proximal transverse colon, near the hepatic flexure, free spillage of contrast into the peritoneal cavity occurred. The examination was immediately stopped. The catheter was removed and the infant rapidly returned to the NICU by the transport team. The NICU Fellow and Pediatric Surgery were immediately notified.