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[Sonography of congenital abnormalities of the gastrointestinal tract]
T Riebel1, A Würfel, A Gasiorek-Wiens
1Pädiatrische Radiologie Universitätsklinikum Rudolf Virchow, Standort Wedding, Freie Universität Berlin.
Insights
Ultrasound effectively diagnoses congenital gastrointestinal anomalies in children, identifying passage disturbances and lesions. This imaging modality can reduce the need for additional X-rays, improving diagnostic efficiency.
Area of Science:
- Pediatric Surgery
- Diagnostic Imaging
- Gastroenterology
Background:
- Congenital gastrointestinal anomalies present significant diagnostic challenges in pediatric patients.
- Accurate and timely diagnosis is crucial for effective surgical intervention and improved outcomes.
- Existing diagnostic methods may involve multiple imaging modalities, increasing patient exposure and healthcare costs.
Purpose of the Study:
- To evaluate the diagnostic accuracy of ultrasound in identifying congenital gastrointestinal anomalies in children.
- To assess the role of ultrasound in documenting passage disturbances and causative lesions.
- To determine the potential for reducing reliance on additional radiographic examinations.
Main Methods:
- Sonographic documentation of passage disturbances and lesions in 12 children with congenital gastrointestinal anomalies.
- Prenatal diagnosis in 3 neonates, including complications like meconium peritonitis.
- Comparison of ultrasound findings with subsequent radiological and surgical results.
Main Results:
- Ultrasound accurately identified passage disturbances and causative lesions in all pediatric patients.
- Prenatal ultrasound correctly diagnosed anomalies and complications in neonates.
- Ultrasound findings were consistently sufficient for surgical planning, obviating the need for additional X-rays in many cases.
Conclusions:
- Ultrasound is a highly effective tool for diagnosing congenital gastrointestinal anomalies in children.
- Routine use of ultrasound can significantly decrease the necessity for supplementary X-ray examinations.
- Increased emphasis on intrauterine sonographic documentation of these anomalies is recommended.
Abstract:
In 12 children aged from 1 day to 15 years with various kinds of congenital gastrointestinal anomaly (atresia/stenosis in the duodenum, jejunum, or ileum; duplication cyst in the duodenum/Bauhin's valve; ectopic pancreas antropyloric) the almost invariably present disturbance of passage was sonographically documented and located and, in the cases with concomitant processes of the bowel wall, the causative lesion demonstrated. In 3 neonates, the diagnosis including complications (meconium peritonitis with calcifications secondary to small bowel perforation) had already been accurately made prenatally. Despite the always unequivocal ultrasound findings, additional x-ray examinations (only plain in 5, only with contrast medium in 1, plain and with contrast medium in 6 cases) were performed in all patients to confirm the diagnosis and reassure the operator. Comparison of the sonographic with the radiological and, later, with the surgical results showed that, in all cases, ultrasound had already provided the information essential to the surgical intervention. The results indicate that, in future, a substantial reduction of additive x-ray examinations is possible in such diseases and that their early intrauterine sonographic documentation should be attempted much more frequently.