Bowel necrosis in necrotizing enterocolitis in newborns

(A) Color Doppler sonogram shows three bowel loops (arrows and arrowhead). The two outer loops (arrows) are markedly hyperemic, with flow around the entire circumference of each loop and some prominent mesenteric vessels. The central loop has an irregular wall with focal thinning at one site (arrowhead) and small hyperechoic foci suggestive of intramural gas. There is no flow in the wall, a finding highly suggestive of necrosis.
(B) Intraoperative photograph of the bowel shows the necrotic bowel loop (arrow).