Diagnostic value of ultrasound in ischemic changes of intestinal volvulus in children

doi:10.3877/cma.j.issn.2095-2015.2024.06.016

Abstract

Abstract:

Objective

To investigate the value of ultrasonic signs in the diagnosis of intestinal volvulus and the evaluation of intestinal ischemic changes in children.

Methods

The clinical and ultrasonic data of 77 cases with intestinal volvulus confirmed by operation and pathology and preoperative ultrasound examination were retrospectively analyzed. According to the presence or absence of intestinal ischemic changes during operation，they were divided into an ischemic group （with intestinal ischemic changes） and a control group （without intestinal ischemic changes），and differences of clinical features and incidence of each ultrasonic sign between the two groups were compared.

Results

The comparison of clinical data between the two groups showed that the age distribution of the ischemic group was significantly lower than that of the control group，with a statistically significant difference （P＜0.05）.Comparison of the ultrasonic signs between the two groups showed that the incidence of turbid ascites，intestinal dilation，mesenteric edema，and enhanced intestinal wall echo in the ischemic group were higher than that in the control group，with a statistically significant differences （P＜0.05）. The results of ROC showed that the AUC of turbid ascites，intestinal dilatation，mesenteric edema and enhanced intestinal wall echo predicting ischemic changes of intestinal torsion were 0.677，0.654，0.612 and 0.596，respectively.

Conclusion

In children with intestinal volvulus，the younger the age，the more ultrasound signs such as turbid ascites，intestinal dilation，mesenteric edema，and enhanced intestinal wall echo are present，which are prone to intestinal ischemia.

Key words: Intestinal volvulus, Children, Ultrasonic examination, Intestinal ischemia

Chen Zhang, Ming Qin, Juan Dong, Yulong Chen. Diagnostic value of ultrasound in ischemic changes of intestinal volvulus in children[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(06): 565-568.

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References 13

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组别	例数	男/女（例）	中位年龄（d）	术中肠扭转度数（中位数）	继发因素[例（%）]
有肠缺血改变	37	26/11	6	360	8（21.6）
无肠缺血改变	40	32/8	18	360	9（22.5）
χ ²/Z		1.270	-2.774	-0.712	0.009
P		0.260	0.006	0.476	0.926

组别	例数	男/女（例）	中位年龄（d）	术中肠扭转度数（中位数）	继发因素[例（%）]
有肠缺血改变	37	26/11	6	360	8（21.6）
无肠缺血改变	40	32/8	18	360	9（22.5）
χ ²/Z		1.270	-2.774	-0.712	0.009
P		0.260	0.006	0.476	0.926

超声征象	有肠缺血改变（n=37）	无肠缺血改变（n=40）	χ ²	P
漩涡征	19（51.4）	29（72.5）	3.662	0.056
SMA塌陷	10（27.0）	9（22.5）	0.212	0.645
浑浊腹水	14（37.8）	1（2.5）	15.302	＜0.001
肠管扩张	16（43.2）	5（12.5）	9.159	0.002
肠壁增厚	8（21.6）	3（7.5）	3.130	0.077
肠系膜水肿	12（32.4）	4（10.0）	5.876	0.015
肠壁回声增强	8（21.6）	1（2.5）	-	0.012
咖啡豆征	3（8.1）	0（0）	-	0.106
囊性肿块	1（2.7）	0（0）	-	0.481
门静脉积气	1（2.7）	0（0）	-	0.481

超声征象	有肠缺血改变（n=37）	无肠缺血改变（n=40）	χ ²	P
漩涡征	19（51.4）	29（72.5）	3.662	0.056
SMA塌陷	10（27.0）	9（22.5）	0.212	0.645
浑浊腹水	14（37.8）	1（2.5）	15.302	＜0.001
肠管扩张	16（43.2）	5（12.5）	9.159	0.002
肠壁增厚	8（21.6）	3（7.5）	3.130	0.077
肠系膜水肿	12（32.4）	4（10.0）	5.876	0.015
肠壁回声增强	8（21.6）	1（2.5）	-	0.012
咖啡豆征	3（8.1）	0（0）	-	0.106
囊性肿块	1（2.7）	0（0）	-	0.481
门静脉积气	1（2.7）	0（0）	-	0.481

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