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Assessment of retromesenteric position of the third portion of the duodenum: an US feasibility study in 33 newborns

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Abstract

Background

US can be used to assess bowel and does not require ionizing radiation or the administration of contrast material. Prior studies of the duodenum with US are limited.

Objective

This study assesses the success rate of US demonstration of the third portion of the duodenum (D3) between the superior mesenteric artery (SMA) and the aorta in newborns to exclude malrotation based on embryologic and anatomic principles.

Material and methods

Thirty-three newborns underwent US studies. The structures between the SMA and the aorta, including D3, were evaluated in axial and longitudinal planes. The length of time to acquire diagnostic images was recorded.

Results

In both the axial and longitudinal planes, D3 was seen between the SMA and the aorta in all 33 infants, including some with abundant bowel gas. The mean length of time to acquire diagnostic images was 34 s.

Conclusion

Bedside US successfully illustrated the retromesenteric position of D3 in all 33 infants. Overlying gas-filled bowel was effectively effaced by graded compression. The short study duration indicates the practicality of the method. Further studies in broader patient populations and in correlation with other imaging and/or surgical findings is required to validate our technique.

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Acknowledgements

The authors wish to thank Dr. David Paushter for his encouragement and support; Dr. William Meadow, neonatologist, for authorizing our study; Dr. Mario Zaritzky for his expertise as a former pediatric surgeon and his computer assistance, and Pennie Stivan for facilitating technologists’ participation. We also thank Sheila A. Mitchell for her secretarial assistance.

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Correspondence to David K. Yousefzadeh.

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Yousefzadeh, D.K., Kang, L. & Tessicini, L. Assessment of retromesenteric position of the third portion of the duodenum: an US feasibility study in 33 newborns. Pediatr Radiol 40, 1476–1484 (2010). https://doi.org/10.1007/s00247-010-1709-4

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  • DOI: https://doi.org/10.1007/s00247-010-1709-4

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