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Role of upper gastrointestinal contrast studies for suspected malrotation in neonatal population
Author(s) -
Birajdar Suresh,
Rao Shripada C,
Bettenay Fiona
Publication year - 2017
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13515
Subject(s) - medicine , intestinal malrotation , interquartile range , laparotomy , gestational age , pediatrics , surgery , obstetrics , pregnancy , genetics , biology
Aim Upper gastrointestinal ( UGI ) contrast study is the preferred radiological investigation to diagnose malrotation of intestine. We aimed to review the role of UGI contrast in neonates (term and preterm) who were clinically suspected to have malrotation. Methods The study included a retrospective review of medical charts and radiology reports. Results A total of 164 newborn infants underwent UGI contrast study to rule out malrotation during the study period (2006–2015). Median gestational age at the time of presentation was 38 weeks (interquartile range: 35.5–39.6 weeks). Median age for clinical presentation was day 2 of life (interquartile range: 2–5 days). Out of the 164 contrast studies, 112 were normal, whereas 52 were reported to have malrotation. Of those 52 infants, 47 were confirmed to have malrotation on surgery (positive predictive value: 90). Of the 112 infants with normal UGI contrasts, nine infants underwent laparotomy for ongoing clinical symptoms out of which four infants were diagnosed to have malrotation on laparotomy. There were 22 infants born at gestational age <32 weeks, who underwent UGI contrast studies to rule out malrotation. Their clinical symptoms were similar to necrotising enterocolitis. Of 22 preterm contrast studies, six were reported to have malrotation; of these, five had surgically confirmed malrotation. No complications related to the contrast study were noted in both term and preterm infants. Conclusion Current study reaffirms the role of UGI contrast study as the investigation of choice for diagnosis of malrotation, in both term and preterm infants. UGI contrast is safe and well tolerated even in preterm infants.