Is color Doppler a reliable method for the diagnosis of malrotation?

Karaman, Íbrahím; Karaman, Ayşe; Çınar, Hasibe Gökçe; Ertürk, Ahmet; Erdoğan, Derya; Özgüner, İsmet Faruk

doi:10.1007/s10396-017-0794-5

Cited by 12 publications

(6 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These results are not compatible with the ones in some reports revealing 93.8% sensitivity and 100% specificity for Doppler US. 9 This difference may be due to the small number of cases having non-specific symptoms in that study9 in contrast to our study.…”

Section: Discussioncontrasting

confidence: 61%

“…In recent decades, Doppler US has becoming the first choice diagnostic tool in diagnosis of malrotation since it has less radiation risk. 6,9,10 The diagnostic findings in Doppler US are twisting of SMV around SMA, namely whirlpool sign, and inversion of SMA and SMV course. 10,13 Although it is dependent on the experience of radiologist, it can also be performed as a fast diagnostic method called point-of-care US especially in emergency conditions.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 In recent decade, Doppler ultrasonography (US) has becoming the first diagnostic tool choice in the diagnosis of malrotation with an advantage of no radiation risk. 6,9,10 Although there are well-defined sonographic signs of malrotation in the literature, it was also stated that the normally located superior mesenteric vein does not exclude malrotation. 6 Therefore, we conducted a study reviewing the historical medical records of our cases to evaluate the predictability of clinical and radiological findings in the diagnosis of malrotation.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of the predictability of clinical and radiological findings in the diagnosis of malrotation

et al. 2022

View full text Add to dashboard Cite

Background. To evaluate the predictability of clinical and radiological findings in the diagnosis of malrotation. Methods. Between 2010 and 2020, children with presumptive diagnosis of malrotation were included. The demographic features, clinical and radiological findings, operative findings and outcome were recorded. The upper gastrointestinal series (UGIS) were evaluated by two radiologists. All parameters were correlated with surgical findings to evaluate the predictability. Results. Seventy patients were included. The presenting symptom was bilious vomiting in 29 cases (41.4%), and atypical symptoms (non-bilious vomiting, food refusal, etc.) in 40 cases (57%). One of the cases (1.6%) was asymptomatic and diagnosed incidentally during UGIS. 52 cases had abdominal X-ray and 14 (26.9%) of them were normal. Doppler ultrasonography (US) (n=20) revealed evidence of malrotation in 13 cases (65%). The location of duodenojejunal junction (DJJ) in UGIS was compatible with malrotation in 33 cases. 48 (61%) cases underwent surgical exploration; 35 cases had malrotation and seven cases had midgut volvulus. Median followup time was one year (0.5-7 years). Volvulus has recurred in one case and another case operated for volvulus died because of short bowel syndrome. The statistical analysis for predictability revealed that bilious vomiting (sensitivity: 57.1%, specificity: 82.1%), Doppler US (sensitivity: 92.3%, specificity: 75%) and right-sided DJJ in UGIS (sensitivity: 96.8%, specificity: 75%) have highest predictability. Conclusions. The bilious vomiting, Doppler US findings and right-sided DJJ have the highest predictability to confirm the diagnosis. However, presenting with atypical symptoms and having atypical or normal findings in UGIS do not rule out malrotation.

show abstract

Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of the predictability of clinical and radiological findings in the diagnosis of malrotation

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Us-color Doppler may have some limits when unaccompanied by UGI, such as operator-dependency and presence of gas artifacts which reduce the quality of images and the accuracy and reliability of the exam [ 11 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of upper gastrointestinal series in children with suspected intestinal malrotation

Girolamo,

Emanuela,

et al. 2023

Updates Surg

View full text Add to dashboard Cite

Intestinal malrotation (IM) results from an altered or incomplete rotation of the fetal midgut around the superior mesenteric artery axis. The abnormal anatomy of IM is associated with risk of acute midgut volvulus which can lead to catastrophic clinical consequences. The upper gastro-intestinal series (UGI) is addressed as the gold standard diagnosis procedure, but a variable failure degree has been described in literature. The aim of the study was to analyze the UGI exam and describe which features are the most reproducible and reliable in diagnosing IM. Medical records of patients surgically treated for suspected IM between 2007 and 2020 at a single pediatric tertiary care center were retrospectively reviewed. UGI inter-observer agreement and diagnostic accuracy were statistically calculated. Images obtained with antero-posterior (AP) projections were the most significant in terms of IM diagnosis. Duodenal-Jejunal Junction (DJJ) abnormal position resulted to be the most reliable parameter (Se = 0.88; Sp = 0.54) as well as the most readable, with an inter-reader agreement of 83% (k = 0.70, CI 0.49–0.90). The First Jejunal Loops (FJL), caecum altered position and duodenal dilatation could be considered additional data. Lateral projections demonstrated an overall low sensitivity (Se = 0.80) and specificity (Sp = 0.33) with a PPV of 0.85 and a NPV of 0.25. UGI on the sole AP projections ensures a good diagnostic accuracy. The position of the third portion of the duodenum on lateral views showed an overall low reliability, therefore it was not helpful but rather deceiving in diagnosing IM.

show abstract

“…Водночас, за наявності роздутого шлунка або товстої кишки, спленомегалії, пухлин нирки та заочеревинного простору або сколіозу рентгенологічна картина може симулювати мальротацію, що зумовлює встановлення помилкового діагнозу та обрання неадекватної тактики лікування [2,14]. Крім того, необхідно зважати на променеве навантаження та можливі труднощі при проведенні рентгенконтрастного дослідження [10].…”

Section: вступunclassified

Possibilities of ultrasonography in diagnosis of intestinal malrotation: our own experience and literature review

Pereyaslov¹,

Borova-Halay²,

Nykyforuk³

2018

View full text Add to dashboard Cite

Львівська обласна дитяча клінічна лікарня «ОХМАТДИТ», Україна Мальротація об'єднує широкий спектр вроджених аномалій ротації та фіксації кишок, а запізніла діагностика цієї вади може супроводжуватись життєво небезпечними ускладненнями, особливо у дітей раннього віку. Контрастне дослідження травного каналу у деяких пацієнтів не дає переконливих даних щодо наявності/відсутності мальротації, що вимагає використання інших методів обстеження, зокрема ультрасонографії. Мета навести власні результати ультразвукового обстеження у дітей з мальротацією без клінічних ознак завороту тонкої кишки та дані літератури, які присвячені цій патології. Результати. У двох дітей віком 1,5 місяця та 3 роки, у яких діагноз мальротації було підтверджено під час операції, результати рентгенологічного обстеження не дозволили встановити точний діагноз. При ультрасонографічному обстеженні виявлено інверсію верхніх брижових судин і симптом «виру»(«whirlpool» sign), які, за даними літератури, є типовими для мальротації кишок. На відміну від інших дослідників, які вважають наявність симптому «виру» характерною ознакою завороту середньої кишки, у наведених спостереженнях цей симптом виявили у дітей без проявів завороту. Висновки. Ультрасонографія є ефективним методом діагностики у дітей з підозрою на мальротацію. Наявність інверсії брижових судин та симптому «виру» при ультразвуковому дослідженні вказує на наявність мальротації, навіть за відсутності клінічної картини завороту середньої кишки.

show abstract

Is color Doppler a reliable method for the diagnosis of malrotation?

Cited by 12 publications

References 13 publications

Evaluation of the predictability of clinical and radiological findings in the diagnosis of malrotation

Evaluation of the predictability of clinical and radiological findings in the diagnosis of malrotation

Diagnostic accuracy of upper gastrointestinal series in children with suspected intestinal malrotation

Possibilities of ultrasonography in diagnosis of intestinal malrotation: our own experience and literature review

Contact Info

Product

Resources

About