Saline-Aided Ultrasound as a Primary Investigation Tool in Diagnosis of Duodenal Obstruction in Preterm Infants | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 133, Volume 96, Issue 1, July 2024, Page 3249-3254 PDF (472.52 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2024.381749 | ||||
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| Abstract | ||||
| Background: Congenital duodenal obstruction (CDO) is among the most prevalent causes of neonatal intestine blockage, with an incidence reported as 1 in 2,500 to 10,000 live births. Objective: To evaluate the role of ultrasound (US) with saline infusion in detection of duodenal atresia in preterm infants. Patients and Methods: This prospective cross-sectional study included 50 preterm neonates, aged 1 to 35 days, of both sexes, at the incubation and had repeated bilious vomiting. The neonates underwent saline-aided US and were evaluated using intraoperative findings as the reference standard. US features, such as the double bubble sign, hyperechogenic band, and duodenal web, were assessed. Results: The saline-aided US accurately diagnosed duodenal obstruction in 41 (82%) neonates, with a double bubble sign observed in all cases. The causes of obstruction included annular pancreas (AP) (34%), duodenal atresia (8%), duodenal web (30%), and duodenal malrotation (28%). For detecting AP, the hyperechogenic band had a sensitivity of 76.5%, specificity of 100%, and accuracy of 92% (AUC=0.882), with a perfect agreement (P < 0.001, Kappa = 0.811) between two sonographers. US and surgery had moderate agreement for duodenal atresia detection but perfect agreement for duodenal web and malrotation, with 100% accuracy for both. Conclusions: Saline-aided US is an effective, radiation-free primary diagnostic tool for detecting duodenal obstruction in preterm infants, offering high diagnostic accuracy and excellent agreement with surgical findings. | ||||
| Keywords | ||||
| Saline-aided ultrasound; Duodenal obstruction; Preterm; Neonatal intestinal obstruction; CDO | ||||
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