Radiograph of a baby with<unk>  Diagnosis is usually suspected clinically, but often requires the aid of diagnostic imaging, most commonly radiography, which can show the intestines and may show areas with death tissue or a bowel perforation. Specific radiographic signs of<unk>  are associated with specific Bell's stages of the disease: * Bell's stage 1 (suspected disease): * Mild systemic disease (apnea, lethargy, slowed heart rate, temperature instability) * Mild intestinal signs (abdominal distention, increased gastric residuals, bloody stools) * Nonspecific or normal radiological signs * Bell's stage 2 (definite disease): * Mild to moderate systemic signs * Additional intestinal signs (absent bowel sounds, abdominal tenderness) * Specific radiologic signs (pneumatosis intestinalis or portal venous gas) * Laboratory changes (metabolic acidosis, too few platelets in the bloodstream) * Bell's stage 3 (advanced disease): * Severe systemic illness (low blood pressure) * Additional intestinal signs (striking abdominal distention, peritonitis) * Severe radiologic signs (pneumoperitoneum) * Additional laboratory changes (metabolic and respiratory acidosis, disseminated intravascular coagulation) Ultrasonography has proven to be useful, as it may detect signs and complications of<unk>  before they are evident on radiographs, specifically in cases that involve a paucity of bowel gas, a gasless abdomen, or a sentinel loop. Diagnosis is ultimately made in 5–10% of very-low-birth-weight infants ( Image:Neonatal<unk> , gross pathology 20G0022 lores.Alimentary tract of infant showing intestinal<unk> rosis, pneumatosis intestinalis, and perforation site (arrow) (autopsy) Image:Neonatal<unk> , gross pathology 20G0023 lores.Close-up of intestine of infant showing<unk> rosis and pneumatosis intestinalis (autopsy) Diagnosis of<unk>  is more challenging in premature infants, due to inexplicit symptoms and radiographic signs. The most preterm infant is at highest risk of developing<unk> .
Necrotizing enterocolitis
Sepsis
Neutropenic enterocolitis
Anal fissure
Food protein-induced enterocolitis syndrome
Hirschsprung's disease
Intestinal malrotation
Enterocolitis