Necrotising enterocolitis: To PCT or not to PCT?

A national survey of all 24 national neonatal surgical centres explored preventive strategies for necrotising enterocolitis (NEC). Particular focus was given to the use of procalcitonin (PCT) in other centres, given that Leeds neonatal units have been at the forefront of incorporating the biomarker into sepsis detection and antimicrobial stewardship. National adoption remains limited. Evidence suggests that early elevation of PCT levels may differentiatie surgical from medical NEC and improve diagnostic accuracy when combined with other markers, supporting its potential as an early biomarker of NEC severity.

Erin Frankel
Medical student

Sydnie Harris-Campbell
Medical student

School of Medicine, University of Leeds

Dr Nicola Mullins
Neonatal Consultant

Dr Liz McKechnie
Neonatal Consultant

Dr Ourania Pappa
Post CCT Neonatal SPIN Trainee (2) ourania.pappa@nhs.net

Leeds Centre for Newborn Care, Leeds Children’s Hospital

Frankel E., Harris-Campbell S., Mullins N., McKechnie L., Pappa O. Necrotising enterocolitis: To PCT or not to PCT? Infant 2025; 21(6): 174-78.

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Keywords

procalcitonin (PCT); necrotising enterocolitis (NEC); biomarkers

Key points

The underlying mechanisms that lead to NEC are not completely understood.
NEC is a gastrointestinal disease with a 5-12% incidence in the UK.
Determining accurate predictors of early NEC pathology has been notoriously problematic.

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VOLUME 18 ISSUE 2/MARCH 2022

Coffee bean sign in a preterm neonate on an abdominal X-ray

A preterm male infant presented with abdominal distension and palpable bowel loops at 27 days of life. An abdominal X-ray showed a ‘coffee bean’ appearance of the bowel and raised the possibility of a sigmoid volvulus. Subsequent abdominal X-rays showed resolution of the coffee bean but the presence of intramural gas, and thus the infant was managed conservatively for necrotising enterocolitis. In this case a careful clinical evaluation with early imaging and multidisciplinary team discussion played an important role in ruling out sigmoid volvulus.