Neonatal duodenum: fluid-aided US examination.

Abstract

In 261 infants with vomiting, 11 duodenal abnormalities were diagnosed with fluid-aided ultrasound (US). These abnormalities included duodenal obstruction, malrotation with and without associated volvulus, incomplete rotation, and duodenal stenosis. US was the initial modality used in the evaluation of vomiting in these neonates and young infants. The overall sensitivity and specificity of fluid-aided US evaluation of duodenal abnormalities were 100% and 99%, respectively. (Workup bias limits the reliability of these figures.) Fluid-aided US examination of the stomach and duodenum provided a dynamic view of duodenal rotation and anatomy, and at the very least provided a method of triaging those infants who may require surgery, upper gastrointestinal series, or follow-up US to make a definitive diagnosis.

Sonographic evaluation of superior mesenteric vascular relationship in malrotation

“…In the reported cases the diagnosis was based on the abnormal course of the fluid filled duodenum to the right of the midline or on a duodenal obstruction pattern with an arrowhead configuration of the obstructed segment [14,15].…”

Intestinal malrotation – volvulus: Imaging findings

“…2,6,8 Some authors propose the use of ultrasounds with oral or injected liquid through a jejunal probe to assess the location of the angle of Treitz yet it is a complex proceeding in today's routine clinical practice and we do not have large studies comparing its diagnostic precision with that of gastrointestinal transit. 1,6,33 Recently the fact of confirming the retroperitoneal position of the third duodenal section in its journey between the aorta and the SMA in the axial plane, caudal to the left renal vein and one jejunal vein through the aortomesenteric space 3,23,34,35 has been described as the most reliable sign to preclude malrotation (Fig. 9B).…”

Paediatric ultrasound. I. Abdominal

“…Sometimes it can be useful to fill the upper intestines by drinking water or to apply a saline enema for improved visualisation and distension of the distal bowel and the colon (ªhydrocolonº; Fig. 7a, b) [31,56]. This can be useful in colitis, but also in neonates investigated for low bowel obstruction.…”