Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Gastrointestinal Emergency in Neonates and Infants: A Pictorial Essay

  • Gayoung Choi (Department of Radiology, Korea University Ansan Hospital) ;
  • Bo-Kyung Je (Department of Radiology, Korea University Ansan Hospital) ;
  • Yu Jin Kim (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2021.02.03
  • Accepted : 2021.09.13
  • Published : 2022.01.01
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Abstract

Gastrointestinal (GI) emergencies in neonates and infants encompass from the beginning to the end of the GI tract. Both congenital and acquired conditions can cause various GI emergencies in neonates and infants. Given the overlapping or nonspecific clinical findings of many different neonatal and infantile GI emergencies and the unique characteristics of this age group, appropriate imaging is key to accurate and timely diagnosis while avoiding unnecessary radiation hazard and medical costs. In this paper, we discuss the radiological findings of essential neonatal and infantile GI emergencies, including esophageal atresia and tracheoesophageal fistula, hypertrophic pyloric stenosis, duodenal atresia, malrotation, midgut volvulus for upper GI emergencies, and jejunoileal atresia, meconium ileus, meconium plug syndrome, meconium peritonitis, Hirschsprung disease, anorectal malformation, necrotizing enterocolitis, and intussusception for lower GI emergencies.

Keywords

Acknowledgement

We thank to Chaeyoun Oh for his surgical resources.

References

  1. Stanescu AL, Liszewski MC, Lee EY, Phillips GS. Neonatal gastrointestinal emergencies: step-by-step approach. Radiol Clin North Am 2017;55:717-739
  2. Hernanz-Schulman M, States L, Vasanawala S. Imaging techniques. In: Coley BD, ed. Caffey's pediatric diagnostic imaging, 13th ed. Philadelphia: Elsevier Saunders, 2019:761-776
  3. Hiorns MP. Gastrointestinal tract imaging in children: current techniques. Pediatr Radiol 2011;41:42-54
  4. Bax KM. Esophageal atresia and tracheoesophageal malformations. In: Holcomb GW, Murphy JP, Ostlie DJ, eds. Ashcraft's pediatric surgery, 5th ed. Philadelphia: Elsevier Saunders, 2010:345-361
  5. Mann GS, Rizvi AA, Shabani AG, Rizvi A, Stafrace S. The esophagus. In: Stafrace S, Blickman JG, eds. Radiological imaging of the digestive tract in infants and children, 2nd ed. Cham: Springer, 2016:125-176
  6. Ellis WD. Congenital and neonatal abnormalities. In: Coley BD, ed. Caffey's pediatric diagnostic imaging, 13th ed. Philadelphia: Elsevier Saunders, 2019:901-910
  7. Harmon CM, Coran AG. Congenital anomalies of the esophagus. In: Coran AG, Caldamone A, Adzick NS, Krummel TM, Laberge JM, Shamberger R, eds. Pediatric surgery, 7th ed. Philadelphia: Elsevier Mosby, 2012:893-918
  8. Hellan M, Lee T, Lerner T. Diagnosis and therapy of primary hypertrophic pyloric stenosis in adults: case report and review of literature. J Gastrointest Surg 2006;10:265-269
  9. Hernanz-Schulman M. Hypertrophic pyloric stenosis. In: Coley BD, ed. Caffey's pediatric diagnostic imaging, 13th ed. Philadelphia: Elsevier Saunders, 2019:935-944
  10. Ranells JD, Carver JD, Kirby RS. Infantile hypertrophic pyloric stenosis: epidemiology, genetics, and clinical update. Adv Pediatr 2011;58:195-206
  11. Costa Dias S, Swinson S, Torrao H, Goncalves L, Kurochka S, Vaz CP, et al. Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis. Insights Imaging 2012;3:247-250
  12. Blumhagen JD, Maclin L, Krauter D, Rosenbaum DM, Weinberger E. Sonographic diagnosis of hypertrophic pyloric stenosis. AJR Am J Roentgenol 1988;150:1367-1370
  13. Navarro OM, Siegel MJ. Gastrointestinal tract. In: Siegel MJ, ed. Pediatric sonography, 5th ed. Philadelphia: Wolters Kluwer, 2019:346-395
  14. Hernanz-Schulman M. Duodenum and small bowel: congenital and neonatal abnormalities. In: Coley BD, ed. Caffey's pediatric diagnostic imaging, 13th ed. Philadelphia: Elsevier Saunders, 2019:953-978.
  15. Applebaum H, Sydorak R. Duodenal atresia and stenosis-annular pancreas. In: Coran AG, Caldamone A, Adzick NS, Krummel TM, Laberge JM, Shamberger R, eds. Pediatric surgery, 7th ed. Philadelphia: Elsevier Mosby, 2012:1051-1057
  16. Strouse PJ. Disorders of intestinal rotation and fixation ("malrotation"). Pediatr Radiol 2004;34:837-851
  17. Sizemore AW, Rabbani KZ, Ladd A, Applegate KE. Diagnostic performance of the upper gastrointestinal series in the evaluation of children with clinically suspected malrotation. Pediatr Radiol 2008;38:518-528
  18. Orzech N, Navarro OM, Langer JC. Is ultrasonography a good screening test for intestinal malrotation? J Pediatr Surg 2006;41:1005-1009
  19. Pracros JP, Sann L, Genin G, Tran-Minh VA, Morin de Finfe CH, Foray P, et al. Ultrasound diagnosis of midgut volvulus: the "whirlpool" sign. Pediatr Radiol 1992;22:18-20
  20. Grosfeld JL, Ballantine TV, Shoemaker R. Operative mangement of intestinal atresia and stenosis based on pathologic findings. J Pediatr Surg 1979;14:368-375
  21. Frischer JS, Azizkhan RG. Jejunoileal atresia and stenosis. In: Coran AG, Caldamone A, Adzick NS, Krummel TM, Laberge JM, Shamberger R, eds. Pediatric surgery, 7th ed. Philadelphia: Elsevier Mosby, 2012:1059-1071
  22. Chang PT, Lee EY, Restrepo R, Eisenberg RL. Gastrointestinal tract filling defects in pediatric patients. AJR Am J Roentgenol 2014;203:W3-W13
  23. Haber HP. Cystic fibrosis in children and young adults: findings on routine abdominal sonography. AJR Am J Roentgenol 2007;189:89-99
  24. Arca MJ, Oldham KT. Atresia, stenosis, and other obstructions of the colon. In: Coran AG, Caldamone A, Adzick NS, Krummel TM, Laberge JM, Shamberger R, eds. Pediatric surgery, 7th ed. Philadelphia: Elsevier Mosby, 2012:1247-1253
  25. Siegel MJ, Coley BD. Esophagus and gastrointestinal tract. In: Siegel MJ, Coley BD, eds. Pediatric imaging. Philadelphia: Lippincott Williams & Wilkins, 2006:199-258
  26. Hernanz-Schulman M. Congenital and neonatal disorders. In: Coley BD, ed. Caffey's pediatric diagnostic imaging, 13th ed. Philadelphia: Elsevier Saunders, 2019:1008-1023
  27. Berrocal T, Lamas M, Gutieerrez J, Torres I, Prieto C, del Hoyo ML. Congenital anomalies of the small intestine, colon, and rectum. Radiographics 1999;19:1219-1236
  28. Moore SW. The contribution of associated congenital anomalies in understanding Hirschsprung's disease. Pediatr Surg Int 2006;22:305-315
  29. DiPerna S, Buonomo C. Gastrointestinal imaging. In: Walters M, Robertson RL, eds. Pediatric radiology: the requisites, 4th ed. Philadelphia: Elsevier Inc, 2016:91-117
  30. Yan J, Sun J, Wu R, Tan SS, Chen Y, Peng Y, et al. Barium enema findings in total colonic aganglionosis: a single-center, retrospective study. BMC Pediatr 2020;20:499
  31. Herman RS, Teitelbaum DH. Anorectal malformations. Clin Perinatol 2012;39:403-422
  32. Alamo L, Meyrat BJ, Meuwly JY, Meuli RA, Gudinchet F. Anorectal malformations: finding the pathway out of the labyrinth. Radiographics 2013;33:491-512
  33. Kim IO, Han TI, Kim WS, Yeon KM. Transperineal ultrasonography in imperforate anus: identification of the internal fistula. J Ultrasound Med 2000;19:211-216
  34. Niedzielski JK. Invertography versus ultrasonography and distal colostography for the determination of bowel-skin distance in children with anorectal malformations. Eur J Pediatr Surg 2005;15:262-267
  35. Choi YH, Kim IO, Cheon JE, Kim WS, Yeon KM. Imperforate anus: determination of type using transperineal ultrasonography. Korean J Radiol 2009;10:355-360
  36. McHugh K. The role of radiology in children with anorectal anomalies; with particular emphasis on MRI. Eur J Radiol 1998;26:194-199
  37. Sylvester KG, Liu GY, Albanese CT. Necrotizing enterocolitis. In: Coran AG, Caldamone A, Adzick NS, Krummel TM, Laberge JM, Shamberger R, eds. Pediatric surgery, 7th ed. Philadelphia: Elsevier Mosby, 2012:1187-1207
  38. Kliegman RM, Walsh MC. Neonatal necrotizing enterocolitis: pathogenesis, classification, and spectrum of illness. Curr Probl Pediatr 1987;17:213-288
  39. Morrison SC, Jacobson JM. The radiology of necrotizing enterocolitis. Clin Perinatol 1994;21:347-363
  40. Marchildon MB, Buck BE, Abdenour G. Necrotizing enterocolitis in the unfed infant. J Pediatr Surg 1982;17:620-624
  41. Applegate KE, Hernanz-Schulman M. Intussusception. In: Coley BD, ed. Caffey's pediatric diagnostic imaging, 13th ed, Philadelphia: Elsevier Saunders, 2019:1040-1049
  42. Columbani PM, Scholz S. Intussusception. In: Coran AG, Caldamone A, Adzick NS, Krummel TM, Laberge JM, Shamberger R, eds. Pediatric surgery, 7th ed. Philadelphia: Elsevier Mosby, 2012:1093-1110
  43. Cogley JR, O'Connor SC, Houshyar R, Al Dulaimy K. Emergent pediatric US: what every radiologist should know. Radiographics 2012;32:651-665
  44. Daneman A, Alton DJ. Intussusception. Issues and controversies related to diagnosis and reduction. Radiol Clin North Am 1996;34:743-756
  45. Hernandez JA, Swischuk LE, Angel CA. Validity of plain films in intussusception. Emerg Radiol 2004;10:323-326
  46. Hryhorczuk AL, Strouse PJ. Validation of US as a first-line diagnostic test for assessment of pediatric ileocolic intussusception. Pediatr Radiol 2009;39:1075-1079
  47. del-Pozo G, Gonzalez-Spinola J, Gomez-Anson B, Serrano C, Miralles M, Gonzalez-deOrbe G, et al. Intussusception: trapped peritoneal fluid detected with US--relationship to reducibility and ischemia. Radiology 1996;201:379-383
  48. Sadigh G, Zou KH, Razavi SA, Khan R, Applegate KE. Meta-analysis of air versus liquid enema for intussusception reduction in children. AJR Am J Roentgenol 2015;205:W542-W549
  49. Gorenstein A, Raucher A, Serour F, Witzling M, Katz R. Intussusception in children: reduction with repeated, delayed air enema. Radiology 1998;206:721-724
  50. Dahab MM, AbouZeid AA, Mohammad SA, Safoury HS. The second trial pneumatic reduction for idiopathic intussusception: therapeutic effect and hazards. Ann Pediatr Surg 2012;8:77-79