Learning objectives
To describe the various radiologic imaging appearances of gastro-intestinal obstruction in newborn throughout the GI tract – stomach,
small bowel,
cecal and sigmoid colon– in conventional radiology,
US and gastrointestinal series.
Background
Gastro-intestinal obstruction disease in newborn is not a rare entity.
Promt diagnosis is necessary to avoid perforation,
ischemia and other severe complications.
The clinical symptoms often are nonspecific,
with acute or chronic presentation,
and radiologists often play a vital role to make the diagnostic,
to discover the etiology and to better guide the therapy.
Sometimes convetional radiology is enough to make the diagnosis,
but in other cases Gastrointestinal series are necessary.
US can play a role in the valoration of complications.
Imaging findings OR Procedure details
We review newborn diagnosed of intestinal obstruction in our department to illustrate a wide spectrum of anomalies (fig.
2):
–Congenital anomalies
Atresia/Stenosis
Peritoneal bands,
duplication cyst,
malrotation,
Meckel diverticulum…
Hirschsprung disease.
–Functional anomalies:
Meconium ileus.
Functional immaturity of the colon
They also can be classificated according to the site of obstruction (Fig.
3):
1.
Gastric (fig 4)(Fig.5)
Gastric atresia (Fig.
6)
Hypertrophic pyloric stenosis (fig.
7) (fig.8)
2.
Duodenum (fig.
9)
Duodenal atresia.
(fig.10)
Annular pancreas (fig.
11) (fig.12)
Malrotation and midgut volvulus.
(fig.13) (fig.14)...
Conclusion
Gastro-intestinal obstruction disease in newborn is not a rare entity.
Its clinic is nonspecific and cannot accurately predict the superimposed complications.
Thus,
imaging tests play a fundamental role in the diagnosis of this clinical entity.
Knowledge of radiologic findings allows prompt diagnosis correct and correct management.
References
•Teresa Berrocal,
Manuel Lamas,
Julia Gutiérez,
Isabel Torres,
Consuelo Prieto and Maria Luisa del Hoyo; Congenital Anomalies of the Small Intestine,
Colon,
and Rectum.
Radiographics September 1999 19:1219-1236
•Teresa Berrocal,
Isabel Torres,
Julia Gutiérez,
Consuelo Prieto,
Maria Luisa del Hoyo and Manuel Lamas; Congenital Anomalies of the Upper Gastrointestinal Tract.
Radiographics July 1999 19:855-872
•Gans SL.
Classification of anorectal anomalies: a critical analysis.
J Pediatr Surg 1970; 5:511-513
•Oppenheimer DA,
Carroll BA,
Shochat SJ.
Sonography of imperforate anus.
Radiology 1983; 148:127-128
