Ultrasound for the diagnosis of malrotation and volvulus in children and adolescents: a systematic review and meta-analysis.
gastroenterology
neonatology
Journal
Archives of disease in childhood
ISSN: 1468-2044
Titre abrégé: Arch Dis Child
Pays: England
ID NLM: 0372434
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
01
11
2020
revised:
15
03
2021
accepted:
28
03
2021
pubmed:
22
4
2021
medline:
22
12
2021
entrez:
21
4
2021
Statut:
ppublish
Résumé
Despite the advantages of ultrasound (US), upper gastrointestinal contrast series (UGI) remains the first-line diagnostic modality in the diagnosis of midgut malrotation and volvulus in children. Evaluate the diagnostic accuracy of US in the diagnosis of malrotation with or without volvulus in children and adolescents aged 0-21 years, compared with the reference standard (diagnosis by surgery, UGI, CT, MRI, and clinical follow-up individually or as a composite). We searched the electronic databases Ovid-MEDLINE, Embase, Scopus, CINAHL, and the Cochrane library in October 2019 and updated on 18 August 2020. Studies evaluating the diagnostic performance of US for diagnosis of midgut malrotation with or without volvulus in children (0-21 years). The data were extracted independently by two authors and a bivariate model was used for synthesis. Meta-analysis of 17 cohort or cross-sectional studies and 2257 participants estimated a summary sensitivity of 94% (95% CI 89% to 97%) and summary specificity of 100% (95% CI 97% to 100%) (moderate certainty evidence) for the use of US for the diagnosis of malrotation with or without midgut volvulus compared with the reference standard. Subgroup analysis and meta-regression revealed better diagnostic accuracy in malrotation not complicated by volvulus, in the neonatal population and enteric fluid administration before US. Moderate certainty evidence suggests excellent diagnostic accuracy and coupled with the advantages, a strong case exists for the use of abdominal US as the first-line diagnostic test for suspected midgut malrotation with or without volvulus in children and adolescents.
Identifiants
pubmed: 33879472
pii: archdischild-2020-321082
doi: 10.1136/archdischild-2020-321082
pmc: PMC8526644
mid: NIHMS1698338
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, N.I.H., Extramural
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1171-1178Subventions
Organisme : NICHD NIH HHS
ID : R03 HD098482
Pays : United States
Organisme : NICHD NIH HHS
ID : R21 HD091718
Pays : United States
Informations de copyright
© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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