الفهرس 
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Abstract
Necrotizing enterocolitis (NEC) is acute inflammatory necrosis of the intestinal tract. It’s the most common acquired gastrointestinal and surgical emergency for preterm infants. NEC also is associated with significant morbidity and mortality Unfortunately, the clinical signs and symptoms of NEC aren’t specific, as it resembles neonatal sepsis in many cases. thus, the diagnosis of NEC is very difficult Moreover, plain X ray which is considered the golden standard for diagnosis of NEC, has low specificity especially early in the course of the NEC and low sensitivity, in addition to its possible harmful effect on patients. so, there is a strong need for ideal diagnostic test with high specificity and sensitivity. Also, the ideal test should be cost effective, available and non-invasive as US, doppler and biomarkers in blood or stool such as fecal calprotectin (FCP). FCP is a 36 kDa protein present in the cytoplasm of the neutrophil and increased in intestinal inflammation This is a case-control study conducted to detect the role of US, doppler and fecal calprotectin in diagnosis of NEC in neonates and whether they have a role in detecting NEC severity and outcome This study conducted in Neonatal Intensive Care Unit of Assiut University Hospital during the period between January 2019 to end of December 2019. The study was conducted on two groups. group 1included 54 neonate with clinical signs diagnosed as NEC. group 2 included 42 healthy control neonates. Both group 1 and 2 were matchable as regard gestational age, weight and sex All the studied subjects had complete medical history, physical examination, and laboratory investigations, including complete blood count, and C-reactive protein, capillary blood gases and blood culture. group 1 was evaluated by modified Bell’s staging criteria which was a clinical classification and management tool for NEC Ultrasound examinations was performed. Color Doppler US examination was done to detect the presence of increased or decreased bowel perfusion. Stool samples were obtained from both groups as soon as possible after the diagnosis of necrotizing enterocolitis in group I The study showed that the incidence of NEC in Assiut University Children hospital was 3.6 %, and the mortality of NEC was 22.2%.There is a highly significant difference between mean±SD of fecal calprotectin level in the NEC group which was 362.61±239.79 µg/ g than in control group which was 61.92±44.16 µg/ g. at the cutoff point of 176 µg/ g, fecal calprotectin could detect most NEC cases with a sensitivity of 87% and specificity of 97.6%.There is a highly significant difference between fecal calprotectin mean±SD in different stages of necrotizing enterocolitis. There was a higher FCP level in stage III which was 237.96±79.32 µg/ g than in stage II which was 75.3±35.78 µg/ g and stage I which was 86.09±18.79 µg/ g. There was a significant difference between FCP mean±SD in relation to outcome with a higher level in died cases. FCP level in died cases was 557.26±319.33 µg/ g and in improved cases was 306.99±180.85 µg/ g. As regard US, there was additional findings that presented by US and couldn’t be detected by X ray as increased or decreased intestinal thickness, decreased peristalsis and ascites.