CT of Small-Bowel Obstruction in Children

Abstract

CT is both sensitive and specific for use in diagnosing small-bowel obstruction in children, especially in children older than 2 years.

Ultrasound in pediatric intestinal obstruction: Assessing its full potential

“…Differentiating between simple and strangulating obstruction is very important as patient's condition in strangulated obstruction deteriorates quickly and hence requires early detection to avoid necrosis and preserve that bowel segment. Significant decrease in the end diastolic volume and increase in the resistive index for the SMA in strangulating obstruction is a marker for urgent laparotomy [4].…”

“…In Indian scena rio, the diagnosis of intestinal obstruction is usually made by clinical evaluation of patient followed by plain abdominal radiography which may show dilated bowel loops and multiple air fluid levels. Inspite of low diagnostic yield [4] it continues to be the initial method of imaging to serve as a basis for triage for further imaging work up. Ultrasonography is an ideal imaging modality in paediatric population because it conveys image in real time, is noninvasive, relatively cost effective and without ionizing radiation.…”

The Radiologic Evaluation of Pediatric Acute Abdomen; Results of Tertiary Referral Center

“…US is not frequently used for the diagnosis of obstruction because of the gas distention in the intestines and also adhesions, which are the the most frequent cause of obstruction [ 33 ]. CT shows a high sensitivity, specificity and reliability in the diagnosis of small bowel obstruction—particularly in children of age over two—that is still not widely used in the diagnosis of obstruction in children [ 34 ].…”

Radiografia e Tomografia Computadorizada do abdome na obstrução do intestino delgado

“…O critério mais aceito na literatura para diagnóstico de obstrução intestinal de delgado é a dilatação da alça maior ou igual a 2,5 cm no eixo transversal, medidos da parede externa de um lado ao outro 3,6,13,15,22 (Figura 3). Para crianças, esse valor é válido se maiores de 1 ano, abaixo disso, a presença de dilatação é um critério subjetivo para o quadro 12 . Um sinal menos comum observado, mas que pode indicar obstrução intestinal, é fecalização de delgado, quando o material intraluminal particulado associado a bolhas de gás é identificado no intestino delgado dilatado, mais frequentemente observado em quadros crônicos.…”

“…Por muitos anos, as radiografias convencionais do abdome em decúbito dorsal e em ortostase, podendo ser acrescida a incidência em perfil com raios horizontais, foram utilizadas como principal método de diagnóstico por imagem, mas estas apresentam eficiência diagnóstica controversa, com estudos divergindo sua acurácia desde 46% até 93% 1,4,[11][12][13] .…”