Diagnostic performance and role of the contrast enema for low intestinal obstruction in neonates

Baad, Michael; Delgado, Jorge; Dayneka, Jillian S.; Anupindi, Sudha A.; Reid, Janet R.

doi:10.1007/s00383-020-04701-4

Cited by 12 publications

(17 citation statements)

References 26 publications

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“…However, in many provinces, there is no consensus on the treatment of enteral nutrition through jejunal tube for neonatal children with high intestinal obstruction surgery, and the postoperative recovery effect of children patients is uneven due to the lack of standard treatment. erefore, it is of great clinical, social, and economic significance to summarize the treatment norms of early enteral nutrition for infants with neonatal high intestinal obstruction after postoperative jejunal catheterization [5].…”

Section: Introductionmentioning

confidence: 99%

Artificial Intelligence Algorithm-Based Computed Tomography Images in the Evaluation of the Curative Effect of Enteral Nutrition after Neonatal High Intestinal Obstruction Operation

Dong

Wang

Zhang

et al. 2021

Journal of Healthcare Engineering

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In this study, CT image technology based on level set intelligent segmentation algorithm was used to evaluate the postoperative enteral nutrition of neonatal high intestinal obstruction and analyze the clinical treatment effect of high intestinal obstruction, so as to provide a reasonable research basis for the clinical application of neonatal high intestinal obstruction. 60 children with high intestinal obstruction treated in the hospital were selected as the research objects. Based on the postoperative enteral nutrition treatment, they were divided into control group (noncatheterization group)-parenteral nutrition support. In the observation group, gastric tube was placed through nose for nutritional support. Then, CT images based on level set segmentation algorithm were used to compare the intestinal recovery of the two groups, and the biochemical indexes and hospitalization were compared. The level set algorithm can accurately segment the lesions in CT images. The segmentation time of the level set algorithm was shorter than that of the traditional algorithm (24.34 ± 2.01 s vs. 75.21 ± 5.91 s), and the segmentation accuracy was higher than that of the traditional algorithm (84.71 ± 3.91% vs. 70.04 ± 3.71%, P < 0.05). The weight of children in the observation group (100 ± 7 g) was higher than that in the control group (54 ± 5 g), and the ICU monitoring time (12.01 ± 2.65 days) and the hospital stay (17.82 ± 3.11 days) were shorter than those in the control group (13.42 ± 2.95 days, 19.13 ± 3.22 days, all P < 0.05). The level set segmentation algorithm can accurately segment the CT image, so that the disease location and its contour can be displayed more clearly. Moreover, the nasal placement of jejunal nutrition tube can effectively improve the intestinal function of children, maintain the steady-state environment of intestinal bacterial growth, and significantly improve the clinical treatment effect, which is worthy of clinical application and promotion.

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Section: Introductionmentioning

confidence: 99%

Artificial Intelligence Algorithm-Based Computed Tomography Images in the Evaluation of the Curative Effect of Enteral Nutrition after Neonatal High Intestinal Obstruction Operation

Dong

Wang

Zhang

et al. 2021

Journal of Healthcare Engineering

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“…However, this modality has a relatively low diagnostic performance for HD and total colonic aganglionosis in neonates. 4,5 Therefore, rectal biopsy should be performed even if the contrast enema findings are normal but the neonate is still suspected to have low intestinal obstruction or any unexplained bowel perforation. 5,13 In this situation, US can be a useful and non-invasive additional imaging modality for neonates with HD or total colonic aganglionosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, Baad et al reported that contrast enema has moderate specificity and low sensitivity for diagnosing HD in neonates. 4 Furthermore, it is difficult to distinguish total colonic aganglionosis from other low intestinal obstructions using contrast enema. 5,6 Although the use of ultrasound (US) in the diagnosis of HD is limited, a few case studies have described the sonographic findings in fetuses and neonates.…”

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confidence: 99%

Sonographic findings of total colonic aganglionosis in a neonate with Haddad syndrome: A case report

Lim

Jung

2022

J of Clinical Ultrasound

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Haddad syndrome is a rare congenital disorder characterized by congenital central hypoventilation syndrome and Hirschsprung disease. Total colonic aganglionosis is a rare and long‐segment form of Hirschsprung disease, which is primarily diagnosed using contrast enemas. However, the diagnostic performance of contrast enemas is relatively low, making the diagnosis of total colonic aganglionosis challenging. In neonates, ultrasound may be used as an additional imaging modality for the diagnosis of Hirschsprung disease. We describe the unique sonographic findings of total colonic aganglionosis in a term neonate with failure to pass meconium and respiratory distress, who was subsequently diagnosed with Haddad syndrome.

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“…Apart from anorectal malformations, which are diagnosed clinically, exact diagnosis of the cause of low intestinal obstruction on the basis of clinical examination and plain X-ray is difficult. Contrast enema (CE) is considered to narrow down the differential diagnosis and may go on to recognize abnormalities like MI, small intestinal atresia (SIA), colonic atresia, small left colon syndrome, and HD [ 6 ]. Many types of contrasts are available but the most commonly used is gastrografin because it has both diagnostic and therapeutic roles.…”

Section: Introductionmentioning

confidence: 99%

“…An exact preoperative diagnosis can change the management plan of the patient [ 6 , 7 ], i.e., MI can be managed medically and HD can be managed in single-stage surgery. A better understanding of the diagnostic modalities related to intestinal obstruction is important.…”

Section: Introductionmentioning

confidence: 99%

Contrast Enema: Solving Diagnostic Dilemmas in Neonates With Lower Intestinal Obstruction

Manzoor¹,

Talat²,

Adnan³

et al. 2022

Cureus

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Background Anatomical abnormalities leading to bowel movement failure are the major cause of intestinal obstruction. This study was done to assess the diagnostic efficacy of contrast enema in neonates with lower intestinal obstruction. Methodology This prospective study was conducted in The Children’s Hospital and University of Child Health Sciences, Lahore from February 2021 to July 2021. Patients presenting with constipation, abdominal distension, vomiting, and unable to pass meconium, evaluated clinically and by X-rays, were included in the study. Patients with lower intestinal obstruction (i.e., meconium ileus, Hirschsprung’s disease, ileal atresia, meconium plug syndrome, and small left colon) were given contrast enema (gastrografin) after hydration. The radiologist was blinded by the clinical diagnosis or reference standard diagnosis, which was labeled prior to image interpretation. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for major contrast enema diagnosis. Results During this period, a total of 34 patients were included in the study. The mean age of presentation was 72.0 ± 24 hours. There were 21 (61.8%) boys and 13 (38.2%) girls, representing a male to female ratio of 1.7:1. In four cases, our diagnosis on the basis of contrast enema was proven wrong. Sensitivity, specificity, PPV, and NPV of Hirschsprung’s disease were found to be 93.3%, 50%, 87.5%, and 66.7%, while these were 84.6%, 66.7%, 91.7%, and 50.0%, respectively, for meconium ileus. Conclusion The diagnostic efficacy of contrast enema was found to be good in neonates with lower intestinal obstruction. The spectrum of intestinal obstruction among neonates shows diversity while contrast enema seems to play a major role in the identification and remodeling of the diagnostic plan in a major proportion of cases.

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Diagnostic performance and role of the contrast enema for low intestinal obstruction in neonates

Cited by 12 publications

References 26 publications

Artificial Intelligence Algorithm-Based Computed Tomography Images in the Evaluation of the Curative Effect of Enteral Nutrition after Neonatal High Intestinal Obstruction Operation

Artificial Intelligence Algorithm-Based Computed Tomography Images in the Evaluation of the Curative Effect of Enteral Nutrition after Neonatal High Intestinal Obstruction Operation

Sonographic findings of total colonic aganglionosis in a neonate with Haddad syndrome: A case report

Contrast Enema: Solving Diagnostic Dilemmas in Neonates With Lower Intestinal Obstruction

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