Articles Vol. 64 No. 4 28/07/2023

15. IMAGING CHARACTERISTICS AND VALUE OF ULTRASOUND AND X-RAY IN THE DIAGNOSIS OF MIDGUT VOLVULUS/ INTESTINAL MALROTATION IN NEONATES

Tran Phan Ninh1,2, Nguyen Van Kien3,4, Nong Thi Chang3,4, Nguyen Van Sang5,6
1 Vietnam National Children’s Hospital
2 Bệnh viện Nhi Trung ương
3 Thai Nguyen University of Medicine and Pharmacy
4 Trường Đại học Y Dược Thái Nguyên
5 E Hospital
6 Bệnh viện E Trung ương
Corresponding author: ninh98@gmail.com
DOI: 10.52163/yhc.v64i4.737
31 Views
12 Downloads
Keywords
Ultrasound, UGI series, midgut volvulus, intestinal malrotation.
Abstract

Purpose: To describe the imaging characteristics and evaluate the value of ultrasound and X-ray in diagnosing midgut volvulus/intestinal malrotation in neonates.

Material and methods: Retrospective cross-sectional description of 250 patients treated in NCH with symptoms of suspected intestinal volvulus, in which 50 patients underwent emergency surgery due to midgut volvulus/intestinal malrotation and 200 patients underwent emergency surgery due to other diseases such as small bowel obstruction, duodenal obstruction, necrotizing enterocolitis. The patients performed abdominal ultrasounds or X-rays before surgery.

Result: The most common sonographic findings were whirlpool sign (52.1%) and SMV/SMA inversion (50%). The most common findings on the UGI series were an abnormal position of DJJ (96.3%) and an abnormal position of jejunal loops (63%), the corkscrew sign is rare (0%). The sensitivity and specificity of ultrasound in diagnosing midgut volvulus are 50% and 100%, respectively. The sensitivity and specificity of UGI series in diagnosing intestinal malrotation are 96.3% and 99%, respectively.

Conclusion: Ultrasound and UGI series were valuable imaging methods in diagnosing midgut volvulus/intestinal malrotation. Combining these imaging modalities should be used to increase diagnostic efficiency.

References
[1]
Zhang W, Sun H, Luo F, The efficiency of Google Scholar
[2]
sonography in diagnosing volvulus in neonates Google Scholar
[3]
with suspected intestinal malrotation. Medicine Google Scholar
[4]
(Baltimore). 2017 Oct;96(42):e8287. Google Scholar
[5]
Zaki M, Gafar AM, Neonatal midgut volvulus: Google Scholar
[6]
Spectrum of findings at color Doppler sonography. Google Scholar
[7]
Egypt J Radiol Nucl Med. 2015;46(2):461-467. Google Scholar
[8]
Hamidi H, Obaidy Y, Maroof S, Intestinal Google Scholar
[9]
malrotation and midgut volvulus. Radiol Case Google Scholar
[10]
Rep. 2016;11(3):271-274. Google Scholar
[11]
Langer JC, Intestinal Rotation Abnormalities Google Scholar
[12]
and Midgut Volvulus. Surg Clin North Am. Google Scholar
[13]
;97(1):147-159. Google Scholar
[14]
Zhou L yao, Li S rong, Wang W et al., Usefulness Google Scholar
[15]
of Sonography in Evaluating Children Suspected Google Scholar
[16]
of Malrotation: Comparison With an Upper Google Scholar
[17]
Gastrointestinal Contrast Study. J Ultrasound Google Scholar
[18]
Med. 2015;34(10):1825-1832. Google Scholar
[19]
Orzech N, Navarro OM, Langer JC, Is Google Scholar
[20]
ultrasonography a good screening test Google Scholar
[21]
for intestinal malrotation? J Pediatr Surg. Google Scholar
[22]
;41(5):1005-1009. Google Scholar
[23]
Taghavi M, Alamdaran SA, Feizi A, Diagnostic Google Scholar
[24]
Value of Ultrasound and Gastrointestinal Series Google Scholar
[25]
Findings in Detection of Pediatric Intestinal Google Scholar
[26]
Malrotation. Iran J Radiol. 2018;15(2): e15089. Google Scholar
[27]
Nguyen HN, Kulkarni M, Jose J et al., Ultrasound Google Scholar
[28]
for the diagnosis of malrotation and volvulus Google Scholar
[29]
in children and adolescents: a systematic Google Scholar
[30]
review and meta-analysis. Arch Dis Child. Google Scholar
[31]
;106(12):1171-1178. Google Scholar