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Roentgenological diagnosis of alimentary tract emergencies in the new born.

Subbarao K - Indian J Radiol Imaging (2008)

View Article: PubMed Central - PubMed

ABSTRACT

An attempt has been made to stress the importance of roentgenological examination in establishing definite preobservation diagnosis in some of the alimentary tract emergencies in the newborn. A brief account of the roentgenological criteria has been given with illustrations of surgically proved cases whereever possible. A short list of pertinent references is appended.

No MeSH data available.


Supine (A) and erect (B) radiographs show a markedly dilated stomach and duodenal loop proximally in the supine position with air-fluid levels in the upright position
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Figure 0003: Supine (A) and erect (B) radiographs show a markedly dilated stomach and duodenal loop proximally in the supine position with air-fluid levels in the upright position

Mentions: Roentgenological examination should be limited to scout films of the abdomen in various views wherever it is possible. From the scout films alone, the point of obstruction could be located as no gas is found beyond the stenotic segment. In case of complete intestinal obstruction, barium should never be administered by mouth. As has been mentioned before, the child might aspirate the barium into the lungs during the act of vomiting or the barium might form a concretion in the bowel, which becomes a hazard to the patient post-operatively after an anastomosis circumventing the atresia has been made. When the atresia or stenosis is in the terminal loops of the ileum and when there is enormous gaseous distension proximally, at times it is difficult to distinguish it from a large bowel distension. As a rule, in all doubtful cases to make out whether it is small or large bowel obstruction, it is always safer to do a barium enema. This helps in ruling out a large bowel obstruction Figure 3 represents a case of complete atresia of a segment of small intestine, extending from the distal duodenum to the proximal jejunum, involving 15 cm of small bowel. In all these cases of obstruction, either an erect or a recumbent lateral film of the abdomen shows the air-fluid levels characteristic of intestinal obstruction. A barium enema also helps in locating the cecum so that any associated nonrotations of the gut can be made out before laparoscopy. Figure 4 represents a case of atresia of a segment of the ileum with volvulus of the involved portion. In this case, barium was administered by mistake, but was promptly aspirated before the operation. The distended proximal loops of bowel as outlined by the contrast material and the absence of gas distal to the obstruction are characteristic of mechanical obstruction, which in the newborn should suggest the diagnosis of some sort of intestinal anomaly.


Roentgenological diagnosis of alimentary tract emergencies in the new born.

Subbarao K - Indian J Radiol Imaging (2008)

Supine (A) and erect (B) radiographs show a markedly dilated stomach and duodenal loop proximally in the supine position with air-fluid levels in the upright position
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2747425&req=5

Figure 0003: Supine (A) and erect (B) radiographs show a markedly dilated stomach and duodenal loop proximally in the supine position with air-fluid levels in the upright position
Mentions: Roentgenological examination should be limited to scout films of the abdomen in various views wherever it is possible. From the scout films alone, the point of obstruction could be located as no gas is found beyond the stenotic segment. In case of complete intestinal obstruction, barium should never be administered by mouth. As has been mentioned before, the child might aspirate the barium into the lungs during the act of vomiting or the barium might form a concretion in the bowel, which becomes a hazard to the patient post-operatively after an anastomosis circumventing the atresia has been made. When the atresia or stenosis is in the terminal loops of the ileum and when there is enormous gaseous distension proximally, at times it is difficult to distinguish it from a large bowel distension. As a rule, in all doubtful cases to make out whether it is small or large bowel obstruction, it is always safer to do a barium enema. This helps in ruling out a large bowel obstruction Figure 3 represents a case of complete atresia of a segment of small intestine, extending from the distal duodenum to the proximal jejunum, involving 15 cm of small bowel. In all these cases of obstruction, either an erect or a recumbent lateral film of the abdomen shows the air-fluid levels characteristic of intestinal obstruction. A barium enema also helps in locating the cecum so that any associated nonrotations of the gut can be made out before laparoscopy. Figure 4 represents a case of atresia of a segment of the ileum with volvulus of the involved portion. In this case, barium was administered by mistake, but was promptly aspirated before the operation. The distended proximal loops of bowel as outlined by the contrast material and the absence of gas distal to the obstruction are characteristic of mechanical obstruction, which in the newborn should suggest the diagnosis of some sort of intestinal anomaly.

View Article: PubMed Central - PubMed

ABSTRACT

An attempt has been made to stress the importance of roentgenological examination in establishing definite preobservation diagnosis in some of the alimentary tract emergencies in the newborn. A brief account of the roentgenological criteria has been given with illustrations of surgically proved cases whereever possible. A short list of pertinent references is appended.

No MeSH data available.