Ultrasound as the first line investigation for midgut malrotation: a UK tertiary centre experience.
Clin Radiol
; 79(2): 150-159, 2024 Feb.
Article
en En
| MEDLINE
| ID: mdl-38007334
ABSTRACT
AIM:
To present the first 22-months experience of transitioning to an ultrasound-first pathway for suspected midgut malrotation. MATERIALS ANDMETHODS:
An "ultrasound-first" imaging pathway was initiated in October 2021. Twenty-two-months later, a search was undertaken of all <1-year-old patients with "bilious", "malrotation," or "volvulus" as the imaging indication. Reports and images from upper gastrointestinal fluoroscopy (UGI) and ultrasound were reviewed, and diagnoses and outcomes were documented.RESULTS:
The search yielded 101 eligible cases between October 2021 and July 2023. Of the patients, 63/101 (62%) had both ultrasound and UGI 47/63 (75%) ultrasound first, 16/63 (25%) UGI first. Thirty-one per cent (31/101) had ultrasound only and 7/70 (10%) UGI only. The pathway diagnosed 7/8 (88%) infants with midgut malrotation with or without volvulus and one infant who had an inconclusive ultrasound examination with a suspected an internal hernia and who was found to have malrotation volvulus at surgery. Twenty-one infants who had confidently normal ultrasound examinations and who also had UGI all had a normal duodenojejunal flexure position. Ultrasound detected alternative pathology in eight children. Duodenal visualisation improved with time 6/15 (40%) in the first 6 months to 23/34 (68%) after the first year.CONCLUSION:
The transition to ultrasound as the first diagnostic test for midgut malrotation can be done safely and effectively in a UK centre, which previously relied solely on UGI.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Vólvulo Intestinal
Límite:
Child
/
Humans
/
Infant
País/Región como asunto:
Europa
Idioma:
En
Revista:
Clin Radiol
Año:
2024
Tipo del documento:
Article