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Ultrasound imaging of bowel obstruction in neonates

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Abstract

Bowel obstruction (BO) in children has a wide differential diagnosis, ranging from non-urgent conditions to surgical emergencies. Abdominal radiographs are most often used as the first imaging modality for the evaluation of obstruction. However, for some indications, ultrasound can be the primary imaging modality. Therefore, it is incumbent on radiologists to recognize the types of bowel obstruction that can be recognized with US. Key sonographic features of BO include differential dilation of bowel loops, bowel wall thickening, and free fluid. “Do Not Miss” findings that indicate need for emergent treatment include volvulus, pneumoperitoneum, and/or signs of ischemia (bowel wall thinning and/or absent perfusion). The aim of this pictorial essay is to provide guidance on the sonographic technique and findings that enable identification of BO on US. Examples of neonatal BO on US, including common and less frequently encountered etiologies, are illustrated in this pictorial essay.

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Authors and Affiliations

  1. Division of Body Imaging, Edward B. Singleton Department of Radiology, Texas Children’s Hospital and Baylor College of Medicine, 6701 Fannin St., Suite 470, Houston, TX, 77030, USA

    Rida Salman, Livja Mertiri, Victor J. Seghers, Andrew C. Sher & Marla B. K. Sammer

  2. Pediatric Section, Department of Radiology, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA

    Desi M. Schiess

  3. Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    HaiThuy N. Nguyen

Authors
  1. Rida Salman
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  2. Livja Mertiri
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  3. Victor J. Seghers
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  4. Desi M. Schiess
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  5. HaiThuy N. Nguyen
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  6. Andrew C. Sher
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  7. Marla B. K. Sammer
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Contributions

All authors contributed to the paper conception and design. LM, DMS, RS: performed material preparation. The first draft of the manuscript was written by RS and all authors commented on subsequent versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Marla B. K. Sammer.

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Supplementary Information

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Supplementary file1 Online Resource 1: Bowel ultrasound scanning protocol (TIFF 353 KB)

Supplementary file2 Online Resource 2: Bowel ultrasound standardized report template (TIFF 306 KB)

Supplementary file3 Online Resource 3: Twelve day-old girl with malrotation and midgut volvulus. Transverse grayscale and color Doppler ultrasound images of the abdomen show abnormal alignment of the SMA and SMV with clockwise whirlpool sign. The third portion of the duodenum was not identified in its normal retroperitoneal course between the aorta and SMA. (MP4 8080 KB)

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Salman, R., Mertiri, L., Seghers, V.J. et al. Ultrasound imaging of bowel obstruction in neonates. J Ultrasound (2024). https://doi.org/10.1007/s40477-023-00858-5

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