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The use of prone films for suspected bowel obstruction in infants and children
Insights
Radiographic evaluation of infant ileus can be accurately diagnosed using prone and cross-table lateral abdominal views. These plain film techniques help identify obstruction and obviate contrast studies.
Area of Science:
- Pediatric Radiology
- Gastrointestinal Imaging
Background:
- Ileus, a common condition in infants and children, requires accurate radiographic assessment.
- Distinguishing between obstructive and nonobstructive ileus is crucial for appropriate management.
Observation:
- Prone frontal and cross-table lateral abdominal views are optimal for evaluating ileus in pediatric patients.
- A series of films, including rectal views, is recommended for comprehensive assessment of large bowel gas.
- In limited study scenarios, prone and left lateral decubitus views are suggested.
Findings:
- Obstructive ileus is characterized by a collapsed rectum with minimal or no air.
- Plain film radiography, particularly with prone views, can often determine the level and cause of obstruction.
- This approach can frequently eliminate the need for fluoroscopic contrast studies.
Implications:
- Plain film radiography offers an effective, non-invasive method for diagnosing pediatric ileus.
- Radiologists can utilize specific views to efficiently identify and characterize bowel obstruction in children.
- The findings support the use of targeted plain film imaging as a primary diagnostic tool.
Abstract:
Prone frontal and cross-table lateral views of the abdomen are recommended as most helpful in radiographic evaluation of infants and children suspected of having obstructive of nonobstructive ileus. A series of films in multiple projections is recommended to evaluate the gas in the large bowel, particularly the rectum. When studies must be limited, prone and left lateral decubitus views are recommended. In obstructive ileus, the collapsed rectum contains little or no air. Utilization of the prone view will often obviate the use of fluoroscopic contrast studies. The level of obstruction, as well as the cause, can often be determined by this plain film approach. Six cases are presented to illustrate these points.