Table 1

Modified Bell’s staging criteria (Kliegman and Walsh7

Modified Bell’s stagingClinical findingsRadiographic findingsGastrointestinal findings
Stage IApnoea, bradycardia and temperature instability.Normal gas pattern or mild ileus.Mild abdominal distension, stool occult blood, gastric residuals.
Stage IIAApnoea, bradycardia and temperature instability.Ileus with dilated bowel loops and focal pneumatosis.Moderate abdominal distension, haematochezia, absent bowel sounds.
Stage IIBMetabolic acidosis and thrombocytopaenia.Widespread pneumatosis, portal venous gas, ascites.Abdominal tenderness and oedema.
Stage IIIAMixed acidosis, coagulopathy, hypotension, oliguria.Moderate to severely dilated bowel loops, ascites, no free air.Abdominal wall oedema, erythema and induration.
Stage IIIBShock, worsening vital signs and laboratory values.Pneumoperitoneum.Bowel perforation.