282 Chapter 13 The most profound limitation of this study was its retrospective nature. Because of these reasons we could not evaluate why some patients did receive a contrast enema whilst others didn’t. It could be that the diagnostic accuracy of the contrast enema would have differed if all patients treated for NEC did receive a contrast enema. Along the same line the reports of contrast enemas are probably only a summary of the actual findings of the radiologists. Still, both the contrast enemas as the surgical procedures, were performed by experienced and specialized medical staff and their reports will have reflected their actual findings. Conclusions Distal intestinal strictures at stoma reversal seem to be identified almost exclusively in patients treated for necrotizing enterocolitis. This is caused by a high incidence of post-NEC strictures which occurs in one in five patients. The contrast enema seems to be capable to detect these strictures with an AUC of 0.98. We therefore conclude that it seems unwise to perform routine contrast enema in all infants prior to stoma reversal, except following treatment for necrotizing enterocolitis.
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