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The diagnostic accuracy of ultrasound and upper gastrointestinal contrast studies for locating atresia/stenosis and intestinal malrotation and detecting annular pancreas in pediatric patients with duodenal atresia/stenosis

  • Original Article–Pediatrics
  • Published:
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Abstract

Purpose

This study aimed to evaluate the diagnostic performance of ultrasound to locate atresia/stenosis and other abdominal anomalies in pediatric patients with duodenal atresia/stenosis, including intestinal malrotation and annular pancreas.

Methods

We classified 36 retrospective cases of duodenal atresia/stenosis based on intestinal malrotation status, and evaluated the diagnostic performance of ultrasound/upper gastrointestinal contrast studies to locate atresia/stenosis and intestinal malrotation, as well as ultrasound for detecting additional anomalies such as annular pancreas. The incidence of annular pancreas was compared between groups using Fisher’s exact test.

Results

Atresia/stenosis was correctly located by ultrasound in 33 (91.7%) cases and by upper gastrointestinal contrast study in 36 (100%) cases. Of the eight cases with intestinal malrotation, five and two were correctly diagnosed by ultrasound and upper gastrointestinal contrast study, respectively. Ultrasound correctly diagnosed annular pancreas in 6/14 cases. The incidence of annular pancreas was significantly different between the groups (present/absent in groups with vs. without intestinal malrotation: 6/2 vs. 8/20, P = 0.036).

Conclusions

Ultrasound has a relatively high capability in locating atresia/stenosis. However, some cases are misdiagnosed. In clinical practice, upper gastrointestinal contrast studies should be used complementarily during diagnosis. Additional anomalies may not be detected by preoperative examinations; therefore, surgeons should carefully evaluate for additional anomalies during surgery, especially coexisting intestinal malrotation and annular pancreas.

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Acknowledgements

We would like to thank Editage for English language editing.

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Authors and Affiliations

  1. Department of Radiology, Saitama Children’s Medical Center, 1-2 Shintoshin, Chuo-ku, Saitama, 330-8777, Japan

    Takahiro Hosokawa, Yutaka Tanami, Yumiko Sato & Eiji Oguma

  2. Department of Surgery, Saitama Children’s Medical Center, 1-2 Shintoshin, Chuo-ku, Saitama, 330-8777, Japan

    Tetsuya Ishimaru & Hiroshi Kawashima

Authors
  1. Takahiro Hosokawa
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  2. Yutaka Tanami
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  3. Yumiko Sato
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  4. Tetsuya Ishimaru
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  5. Hiroshi Kawashima
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  6. Eiji Oguma
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Corresponding author

Correspondence to Takahiro Hosokawa.

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Conflict of interest

Takahiro Hosokawa, Yutaka Tanami, Yumiko Sato, Tetsuya Ishimaru, Hiroshi Kawashima, and Eiji Oguma declare that they have no financial or personal relationships that could lead to a conflict of interest.

Research involving human subjects

This research was performed in accordance with the tenets of the Declaration of Helsinki.

Informed consent

This retrospective study was approved by the ethics committee of our institution, and informed consent was waived.

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Hosokawa, T., Tanami, Y., Sato, Y. et al. The diagnostic accuracy of ultrasound and upper gastrointestinal contrast studies for locating atresia/stenosis and intestinal malrotation and detecting annular pancreas in pediatric patients with duodenal atresia/stenosis. J Med Ultrasonics 49, 299–309 (2022). https://doi.org/10.1007/s10396-021-01176-1

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  • DOI: https://doi.org/10.1007/s10396-021-01176-1

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