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The efficiency of sonography in diagnosing volvulus in neonates with suspected intestinal malrotation.
Medicine (Baltimore). 2017 Oct; 96(42):e8287.M

Abstract

This study is to prospectively evaluate the efficiency of sonography for volvulus diagnosis in neonates with clinically suspected intestinal malrotation.A total of 83 patients with suspected intestinal malrotation who underwent detailed abdominal sonography and upper gastrointestinal contrast study were included. Malrotation was characterized by inversion of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in sonographic examination. The "whirlpool sign" of Color Doppler Sonography was recognized as a characteristic for malrotation with volvulus. The degrees of rotation of the SMV winding around SMA were also detected by sonography. Surgery was performed in patients with sonography diagnosed malrotation.A total of 39 patients were sonographically diagnosed as malrotation which was subsequently confirmed by surgery. The sensitivity and positive predictive value of the sonographic diagnosis were both 100% (39/39). The sensitivity, specificity and accuracy of "whirlpool sign" for the detection of midgut volvulus were 95.2% (20/21), 88.9% (16/18), and 92.3% (36/39), respectively. Greater degrees of rotation (equal or greater than 720°) showed higher risk (odds ratio, 5.0; P < .01) for intestinal necrosis occurrence.Sonography is more accurate in diagnosing suspected malrotation than upper gastrointestinal contrast study. Specific sonographic "whirlpool sign" related to volvulus may be used as a potential indicator for intestinal necrosis. In addition, sonography can exclude malrotation and may help the diagnosis of other diseases, such as annular pancreas and duodenal atresia.

Authors+Show Affiliations

Department of Medical Ultrasonics, Qianfoshan Hospital Affiliated to Shan Dong University, Jinan, China.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

29049228

Citation

Zhang, Wenhua, et al. "The Efficiency of Sonography in Diagnosing Volvulus in Neonates With Suspected Intestinal Malrotation." Medicine, vol. 96, no. 42, 2017, pp. e8287.
Zhang W, Sun H, Luo F. The efficiency of sonography in diagnosing volvulus in neonates with suspected intestinal malrotation. Medicine (Baltimore). 2017;96(42):e8287.
Zhang, W., Sun, H., & Luo, F. (2017). The efficiency of sonography in diagnosing volvulus in neonates with suspected intestinal malrotation. Medicine, 96(42), e8287. https://doi.org/10.1097/MD.0000000000008287
Zhang W, Sun H, Luo F. The Efficiency of Sonography in Diagnosing Volvulus in Neonates With Suspected Intestinal Malrotation. Medicine (Baltimore). 2017;96(42):e8287. PubMed PMID: 29049228.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The efficiency of sonography in diagnosing volvulus in neonates with suspected intestinal malrotation. AU - Zhang,Wenhua, AU - Sun,Hongjun, AU - Luo,Fangqiong, PY - 2017/10/20/entrez PY - 2017/10/20/pubmed PY - 2017/11/2/medline SP - e8287 EP - e8287 JF - Medicine JO - Medicine (Baltimore) VL - 96 IS - 42 N2 - This study is to prospectively evaluate the efficiency of sonography for volvulus diagnosis in neonates with clinically suspected intestinal malrotation.A total of 83 patients with suspected intestinal malrotation who underwent detailed abdominal sonography and upper gastrointestinal contrast study were included. Malrotation was characterized by inversion of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in sonographic examination. The "whirlpool sign" of Color Doppler Sonography was recognized as a characteristic for malrotation with volvulus. The degrees of rotation of the SMV winding around SMA were also detected by sonography. Surgery was performed in patients with sonography diagnosed malrotation.A total of 39 patients were sonographically diagnosed as malrotation which was subsequently confirmed by surgery. The sensitivity and positive predictive value of the sonographic diagnosis were both 100% (39/39). The sensitivity, specificity and accuracy of "whirlpool sign" for the detection of midgut volvulus were 95.2% (20/21), 88.9% (16/18), and 92.3% (36/39), respectively. Greater degrees of rotation (equal or greater than 720°) showed higher risk (odds ratio, 5.0; P < .01) for intestinal necrosis occurrence.Sonography is more accurate in diagnosing suspected malrotation than upper gastrointestinal contrast study. Specific sonographic "whirlpool sign" related to volvulus may be used as a potential indicator for intestinal necrosis. In addition, sonography can exclude malrotation and may help the diagnosis of other diseases, such as annular pancreas and duodenal atresia. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/29049228/The_efficiency_of_sonography_in_diagnosing_volvulus_in_neonates_with_suspected_intestinal_malrotation_ L2 - http://dx.doi.org/10.1097/MD.0000000000008287 DB - PRIME DP - Unbound Medicine ER -