Sonography in the diagnosis of pediatric gastrointestinal obstruction

✍ Scribed by Govind B. Chavhan; Shreyas Masrani; Hemangini Thakkar; Vijay Hanchate; Joseph Lazar; Ashish Wasnik; Abhijit Sunnapwar

• Publisher: John Wiley and Sons
• Year: 2004
• Tongue: English
• Weight: 678 KB
• Volume: 32
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.20016

✦ Synopsis

G astrointestinal (GI) obstruction in children has either congenital or acquired causes. In newborns and infants, congenital disorders such as hypertrophic pyloric stenosis (HPS), duodenal atresia, and midgut volvulus cause GI obstruction; in older children, acquired conditions such as intussusceptions, roundworm infestation, and abdominal tuberculosis are the most common causes.

The clinical presentation of GI obstruction includes pain, vomiting, abdominal distension, and in newborns, failure to pass meconium during the first 24 hours of life. It is the level of obstruction, rather than its specific nature, that determines its clinical and radiological manifestations.

Even though plain radiography and barium studies remain the cornerstone of diagnosis, the use of radiation in children is a matter of concern. Therefore, sonography of the GI tract-which is radiation free, widely available, inexpensive (an important factor in developing countries), and fairly accurate in the diagnosis of GI obstruction-is the recommended alternative. Moreover, it is the modality of choice in diagnosing such conditions as HPS.

This pictorial essay illustrates the sonographic appearances of GI obstructions of various causes in children.

STOMACH HPS, antral diaphragm, duplication cyst, and gastric antral and pyloric atresia can all cause ob-structions in the stomach. HPS is the most common among these causes.