Diagnostic value of high-resolution ultrasound combined with multi-slice computer tomography (MSCT) for pediatric intra-abdominal hernias: a retrospective study.
Child
Internal hernia
Radiological imaging
Retrospective study
Ultrasound
Journal
BMC surgery
ISSN: 1471-2482
Titre abrégé: BMC Surg
Pays: England
ID NLM: 100968567
Informations de publication
Date de publication:
17 Jun 2024
17 Jun 2024
Historique:
received:
09
02
2024
accepted:
10
06
2024
medline:
18
6
2024
pubmed:
18
6
2024
entrez:
17
6
2024
Statut:
epublish
Résumé
To explore the diagnostic value of high-resolution ultrasound combined with multi-slice computer tomography (MSCT) for pediatric intra-abdominal hernias (IAHs), and to analyze the potential causes for missed diagnosis and misdiagnosis of IAHs in children. A retrospective analysis was conducted on 45 children with surgically confirmed IAHs. The diagnostic rate of IAHs by preoperative high-resolution ultrasound combined with MSCT was compared with that of intraoperative examination, and the potential causes for missed diagnosis and misdiagnosis by the combination method were analyzed. Forty-five cases of pediatric IAHs were categorized into primary (25/45, 55.5%) and acquired secondary hernias (20/45, 44.5%). Among children with primary hernias, mesenteric defects were identified as the predominant subtype (40%). Acquired secondary hernias typically resulted from abnormal openings in the abdominal wall or band adhesions due to trauma, surgery, or inflammation. In particular, adhesive band hernias were the major type in children with acquired secondary hernias (40%). The diagnostic rate of high-resolution ultrasound was 77.8%, with "cross sign" as a characteristic ultrasonic feature. Among 10 cases of missed diagnosis or misdiagnosis, 5 were finally diagnosed as IAHs by multi-slice computer tomography (MSCT). Overall, the diagnostic rate of pediatric IAHs by preoperative ultrasound combined with radiological imaging reached 88.9%. IAHs in children, particularly mesenteric defects, are prone to strangulated intestinal obstruction and necrosis. High-resolution ultrasound combined with MSCT greatly enhances the diagnostic accuracy of pediatric IAHs.
Identifiants
pubmed: 38886699
doi: 10.1186/s12893-024-02478-0
pii: 10.1186/s12893-024-02478-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
190Subventions
Organisme : 2019 Nanjing Health Science and Technology Development Special Fund Project
ID : YKK19106
Organisme : the General Project of Science and Technology of Nanjing Medical University
ID : 2015NJMU067
Informations de copyright
© 2024. The Author(s).
Références
Berle M, Dahlslett KH, Kavaliauskiene G, Hoem D. Internal abdominal hernia. Indre tarmbrokk. Tidsskr nor Laegeforen. 2017;137. https://doi.org/10.4045/tidsskr.17.0090 .
Mohakud S, Naik S, Deep N, Singh A, Mishra TS, Sinha M. Transmesenteric Internal Abdominal Hernia: multi-detector row computed tomography findings. Sultan Qaboos Univ Med J. 2021;21:502–3. https://doi.org/10.18295/squmj.4.2021.025 .
doi: 10.18295/squmj.4.2021.025
pubmed: 34522423
pmcid: 8407917
Lanzetta MM, Masserelli A, Addeo G, Cozzi D, Maggialetti N, Danti G, et al. Internal hernias: a difficult diagnostic challenge. Review of CT signs and clinical findings. Acta Biomed. 2019;90:20–37. https://doi.org/10.23750/abm.v90i5-S.8344 .
doi: 10.23750/abm.v90i5-S.8344
pubmed: 31085971
Shehata AE, Helal MA, Ibrahim EA, Magdy B, El Seoudy M, Shaban M, et al. Cecal Volvulus in a child with congenital dilated cardiomyopathy: a case report. Int J Surg Case Rep. 2020;66:30–2. https://doi.org/10.1016/j.ijscr.2019.10.008 .
doi: 10.1016/j.ijscr.2019.10.008
pubmed: 31790948
Azzam A, Abdulkarim AN, Shehata AEM, Mahran I, Arafa A, Arafat A, et al. A report of two infant cases operated for jejunal duplication cyst associated with malrotation and volvulus. Int J Surg Case Rep. 2020;67:227–30. https://doi.org/10.1016/j.ijscr.2020.02.009 .
doi: 10.1016/j.ijscr.2020.02.009
pubmed: 32113129
pmcid: 7047138
Yawei D, Yu W, Xiaoman W, et al. Diagnostic value of Ultrasonography in Intra-abdominal Hernia after congenital choledochal cyst surgery. Chin J Ultrasound Med. 2023;39:780–3. https://doi.org/10.3969/j.issn.1002-0101.2023.07.018 .
doi: 10.3969/j.issn.1002-0101.2023.07.018
Wei C, Xiaoman W, Tingchong Z. Analysis of clinical characteristics of congenital internal hernia in children. Chin J Pediatr Surg. 2017;38:600–4. https://doi.org/10.3760/cma.j.issn.0253-3006 . 2017.08.010.
doi: 10.3760/cma.j.issn.0253-3006
Alzarea A, Aljohani A, Qabani H, Alzahrani A, Sairafi R. A rare case of intestinal obstruction caused by Meckel’s diverticulum band. Annals Med Surg. 2022;78:103807. https://doi.org/10.1016/j.amsu.2022.103807 .
doi: 10.1016/j.amsu.2022.103807
Tada Y, Orihara J, Wada Y, Uchinaka E, Osaki T, Ashida K, et al. Post-colostomy internal hernia of the stomach treated with laparoscopic gastropexy: a case report. Surg Case Rep. 2022;8:105. https://doi.org/10.1186/s40792-022-01455-0 .
doi: 10.1186/s40792-022-01455-0
pubmed: 35644826
pmcid: 9148867
Nguyen J, Siksik JM, Genser L. Intestinal perforation secondary to strangulated internal hernia after Roux-en-Y gastric bypass. J Visc Surg. 2018;155:339–41. https://doi.org/10.1016/j.jviscsurg.2018.03 .
doi: 10.1016/j.jviscsurg.2018.03
pubmed: 29625883
Srisajjakul S, Prapaisilp P, Bangchokdee S. Diagnostic clues, pitfalls, and imaging characteristics of ‘-celes’ that arise in abdominal and pelvic structures. Abdom Radiol (NY). 2020;45:3638–52. https://doi.org/10.1007/s00261-020-02546-y .
doi: 10.1007/s00261-020-02546-y
pubmed: 32356005
Frøkjær JB, Jensen WN, Holt G, Omar HK, Olesen SS. The diagnostic performance and interrater agreement of seven CT findings in the diagnosis of internal hernia after gastric bypass operation. Abdom Radiol (NY). 2018;43:3220–6. https://doi.org/10.1007/s00261-018-1640-y .
doi: 10.1007/s00261-018-1640-y
pubmed: 29845311
Manojlović D, Čekić N, Palinkaš M. Left paraduodenal hernia - A diagnostic challenge: Case report. Int J Surg Case Rep. 2021;85:106138. https://doi.org/10.1016/j.ijscr.2021.106138 .
doi: 10.1016/j.ijscr.2021.106138
pubmed: 34256232
pmcid: 8369286
Blachar A, Federle MP, Brancatelli G, Peterson MS, Oliver JH 3rd, Li W. Radiologist performance in the diagnosis of internal hernia by using specific CT findings with emphasis on transmesenteric hernia. Radiology. 2001;221:422–8. https://doi.org/10.1148/radiol.2212010126 .
doi: 10.1148/radiol.2212010126
pubmed: 11687686
Murphy KP, O’Connor OJ, Maher MM. Adult abdominal hernias. AJR Am J Roentgenol. 2014;202:W506–11. https://doi.org/10.2214/AJR.13.12071 .
doi: 10.2214/AJR.13.12071
pubmed: 24848843
Vijayaraghavan SB. Sonographic features of internal her nia. J Ultrasound Med. 2006;25:105–10. https://doi.org/10.7863/jum.2006.25.1.105 .
doi: 10.7863/jum.2006.25.1.105
pubmed: 16371560
Brezler E, Sico R, Seifarth FG. Midgut Volvulus in a pediatric patient with chronic constipation, congenital intestinal malrotation and internal transmesocolic hernia. BMJ case Rep. 2023;16. 10.1136/bcr-2022-254425.
Yang Q, Zhao F, Qi J, Su L. The comparison of accuracy and practicability between ultrasound and spiral CT in the diagnosis of intestinal obstruction: a protocol for systematic review and meta-analysis. Medicine. 2021;100:e23631. https://doi.org/10.1097/MD.0000000000023631 .
doi: 10.1097/MD.0000000000023631
pubmed: 33530165
pmcid: 7850774
Youssfi M, Goncalves LF. Ultrasound for malrotation and volvulus - point. Pediatric radiology 2022; 52:716 – 22. https://doi.org/10.1007/s00247-021-05154-0 .
Binu V, Nicholson C, Cundy T, Gent R, Piotto L, Taranath A, et al. Ultrasound imaging as the first line of investigation to diagnose intestinal malrotation in children: safety and efficacy. J Pediatr Surg. 2021;5:2224–8. https://doi.org/10.1016/j.jpedsurg.2021.04.009 .
doi: 10.1016/j.jpedsurg.2021.04.009
Guerra M, Iacuzzo C, Scotton G, Biloslavo A, de Manzini N. A rare case of reverse midgut rotation and jejunal transmesenteric internal hernia in an adult with Beckwith-Wiedemann syndrome. Ann Ital Chir. 2021;92:560–4.
pubmed: 34795111
Gerrie SK, Navarro OM. Imaging features of neonatal bowel obstruction. Radiographics. 2023;43:e230035. https://doi.org/10.1148/rg.230035 .
doi: 10.1148/rg.230035
pubmed: 37471246