Radiological evaluation congenital gastrointestinal tract anomalies

ABSTRACT

With the improvements, during recent years, in the control of the infections and nutritional diseases thesubject of congenital malformation becomes of increasing importance. The radiologic signs are crucial for promptdiagnosis of anomalies of alimentary tract and with early identification of resulting complication, surgicaltherapy is usually life-saving. 30 cases of congenital anomalies of alimentary tract in infants were reviewed inrespect of age, sex, incidence and radiological findings. 1. The most common lesion was hypertrophic pyloricstenosis, followed by congenital megacolon and anorectal anomaly, tracheoesophageal fistula, intestinal atresia.2. Male outnumbered female in most congenital anomalies of alimentary tract. 25 cases were under the age of 1month. 3. Common symptoms of upper gastrointestinal tract obstruction are vomiting and abdominal distention. Inthe obstruction of lower gastrointestinal tract, abdominal distention and failure of meconium passage were noted.4. Roentgenologic finding were as follows, a. Chest A-P and lateral view; In tracheoesophageal fistula, sacculardilatation of upper esphagus and displacement of trachea anterolaterally were the most common finding. b. Simpleabdomen Obstructive pattern of proximal portion of duodenum shows in 11 cases, of distal bowel shows in 16 cases.Duodenal atresia showed “double bubble” sing, hypertrophic pyloric stenosis showed marked gastric distention,paucity of air in small bowel and increased gastric peristalsis were the most common finding. Hirschsprung'sdisease showed absence of rectal gas almostly. The variable length between blind hindgut to anus was seen inanorectal anomalies. c. Esophagogram Blind sac of upper esophagus was seen at the 4th thoracic spinal level anddisplacement of trachea anteriolaterally. 1 case of tracheoesophageal fistula had an intact esophageal lumen. d.Upper G-I series; In hypertrophic pyloric stenosis, delayed gastric emptying, string or double tract sign were themost common finding and catapiller sign, tit sign, shoulder sing or open umbrella sign were noted. e. Bariumenema; In congenital megacolon, transitional zone and irregular bizzar contraction, “choppywave” were noted.Radiograph made 24 hours after barium enema showed retained barium in the colon. f. Selective retrogradefistulogram, distal loopgram & voiding cystogram In anorectal anomalies, 3 cases showed rectourethral fistula and2 cases showed rectovaginal fistula and 1 case showed rectovesical fistula. And membranous imperforate anus is in1 case.