Diagnostic function of ultrasonography in malrotation of intestine with midgut volvulus / 中国小儿急救医学

ABSTRACT

Objective Malrotation of intestine with midgut volvulus is a special disease in newbo-rns.It is important of early diagnosis to avoid the risk of intestinal infarct and necrosis.We intended to ex-plore the value of early ultrasonographic diagnosis in malrotation of intestine with midgut volvulus,comparing with upper gastrointestinal imaging.Methods Ultrasonographic features and upper gastrointestinal imaging of 48surgically confirmed malrotation of intestine with midgut volvulus between January 2011and December 2014were retrospectively analyzed.Results All patients were comfirmed by operaion.The rotational degree of midgut volvulus were 90to 720°.In 43of 48patients (89.58%)of malrotation of intestine with midgut volvulus were diagnosed by ultrasonography.The typical ultrasonographic features were called “whirlpool sign”,which was the superior mesenteric vein and the mesentery around the superior mesenteric artery.In 35 of 48(72.92%)patients with malrotation were confirmed by the upper gastrointestinal imaging.The typical sign of the upper gastrointestinal imaging was the helical form of the distal duodenum and proximal jejunum located at middle abdomen.Compared with upper gastrointestinal radiographic examination,ultrasonographic examination had more sensitivity in diagnosis of malrotation of intestine with midgut volvulus (P﹤0.05). Conclusion Ultrasonographic examination have more sensitivity in diagnosis.Noninvasiveness,absence of X-rays,and low costs could make ultrasonographic examination a useful screening test in patients with sus-pected malrotation of intestine with midgut volvulus.“Whirlpool sign”could be considered a specific ultra-sonographic sign in diagnosis of midgut volvulus,which could provide reference for the clinical treatment of malrotation of intestine with midgut volvulus.