The performance of ultrasound and upper gastrointestinal study in diagnosing malrotation in children, with or without volvulus

期刊论文
发表日期：

2024年1月30日

查看全文

Mohamad Sufian Mohamed Burhan,
Hamzaini Abd Hamid,
Faizah Mohd Zaki,
Chai Jia Ning,
Isa Azzaki Zainal,
Izzat Arslan Che Ros,
Che Zubaidah Bt Che Daud,
Mohd Yusran Bin Othman,
Erica Yee Hing

摘要

Background

Rapid diagnosis is crucial for pediatric patients with midgut volvulus and malrotation to prevent serious complications. While the upper gastrointestinal study (UGIS) is the traditional method, the use of ultrasound (US) is gaining prominence.

Objectives

To assess the diagnostic sensitivity and specificity of US compared to UGIS for malrotation and midgut volvulus.

Methods

A cross-sectional study was performed on 68 pediatric patients who underwent US and/or UGIS before surgery for suspected midgut volvulus or malrotation in Kuala Lumpur (PPUKM and HTA), referencing surgical outcomes as the gold standard.

Results

US demonstrated a higher specificity (100%) than UGIS (83%) for diagnosing malrotation, with a slightly lower sensitivity (97% vs. 100%). For midgut volvulus, US surpassed UGIS in sensitivity (92.9% vs. 66.7%) while maintaining comparable specificity. The SMA/SMV criteria showed better sensitivity (91.1%) than the D3 assessment (78.9%) on US, though both had high specificity.

Conclusion

US is equivalent to UGIS for identifying malrotation and is more sensitive for detecting midgut volvulus, supporting its use as a primary diagnostic tool. The study advocates for combined US and UGIS when either yields inconclusive results, optimizing diagnostic precision for these conditions.