Association Between Prenatal Sonographic Findings of Duodenal Obstruction and Adverse Outcomes

Kim, Jee Ye; You, Ji Yeon; Chang, Kylie Hae-Jin; Choi, Suk‐Joo; Oh, Soo‐Young; Seo, Jeong‐Meen; Roh, Cheong‐Rae; Kim, Jong-Hwa

doi:10.7863/ultra.15.09074

Cited by 19 publications

(20 citation statements)

References 35 publications

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“…Uzamış duodenal ileusu önlemek için, mega duodenum (duodenum çapı 5 cm'den büyük olan) olgularında plikasyon ve tapering gerekebilir (16). Çalışmaların sadece 5'inde operasyonlara yer verildiği görüldü (6,7,9,13,15). Bunun sebebi çalışmaların önemli bir kısmının klinik süreçten ziyade hastalığın belirli bir kesitini incelemeyi amaçlamasından kaynaklanmaktadır.…”

Section: Discussionunclassified

“…Operasyonlarda dokuz olguda (% 66.5) tip1 atrezi, beş olguda (%31) annüler pankreas, iki olguda (%12.5) tip 2 atrezi görüldü. Hastalarda ortalama TPN alma süresi 8.4 (6)(7)(8)(9)(10)(11)(12)(13)(14) gün, oral beslenmeye başlama süresi 6.31(5-9) gün ve ortalama yatış süreleri 17.56 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) gündü. Olguların hiçbirinde cerrahi komplikasyon görülmedi ve tüm olgular tam iyileşme ile taburcu edildi.…”

Section: Bulgularunclassified

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Konjenital duodenal obstrüksiyonlarına klinik yaklaşım

Öztorun

Ertürk

Demir

et al. 2020

Turkish Journal of Pediatric Disease

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ÖZAmaç: Yenidoğan dönemindeki intestinal obstruksiyonların çoğunluğunu konjenital duodenal obstrüksiyonlar oluşturur. Preoperatif ve postoperatif yenidoğan yoğun bakım uygulamaları ve uygun nutrisyonel tedaviler sayesinde morbidite ve mortalite önemli derecede azalmasına rağmen, literatürde duodenal obstrüksiyonlara zaman içerisinde yapılan müdahaleleri kıyaslayan çalışmaların yapılmadığı görülmektedir. Çalışmamızda, kliniğimizdeki konjenital duodenal obstruksiyonlu olguların klinik bilgilerini, literatürde sunulan klinik bilgiler ile karşılaştırarak, konjenital duodenal obstruksiyonların tedavisinin zaman içindeki sürecini incelemeyi amaçladık. Gereç veYöntemler: 2006-2016 yıllarında kliniğimizde tedavi edilen konjenital duodenal obstruksiyon tanılı 16 olgu gestasyonel yaşı, cinsiyeti, doğum ağrılığı, başvuru günü, şikayeti, ek anomalileri, ameliyat zamanı, yapılan ameliyat, beslenme zamanı, yatış süresi ve takip açısından retrospektif olarak incelenip literatürdeki benzer çalışmalar ile karşılaştırılarak, günümüzdeki konjenital duodenal obstruksiyonların tedavisinin durumu tartışılmıştır. Bulgular: Dokuz olgu erkek, 7 olgu kız olmak üzere, %69 olgu prematüreydi. Ortalama gestasyonel yaş 34.8 (29-40) haftaydı. Klinik şikayetler 11 olguda kusma, 4 olguda batın distansiyonu ve bir olguda ise genel durum bozukluğutu. Konjenital kalp hastalığı sekiz olguda, Down Sendromu beş olguda ve iki olguda malrotasyon tespit edildi. Cerrahi yöntem olarak en sık olarak 12 olguya Diamond-Shape duodenoduodenostomi uygulandı. Ortalama total parental nutrisyon (TPN) alma süresi 8.4 gün ve ortalama yatış süreleri 17.56 gündü. Olguların tümünde cerrahi komplikasyon görülmeyerek, tam iyileşme ile taburcu edildi.Sonuç: Literatür değerlendirmemizde cerrahi süreçlerin kesitsel olarak verildiği ancak hastalığın bütünsel incelemesinin daha az yapıldığını görüldü. Yapılan karşılaştırmalarda, zaman içerisinde mortalitenin anlamlı şekilde azalma gösterdiği ancak cerrahi tekniklerde ve beslenmeye başlama günü ortalamalarında değişme olmadığı görüldü. Dikkat çekici olarak, sepsis oranlarında artış gözlendi. Literatürdeki olguların çoğunluğunun prematür bebekler olması, hastanede uzun kalış süreleri ve bu olguların göreceli olarak düşük immünitelerinin olması, sepsis oranlarındaki artışı açıklayabilir. Bu durumda, servis şartlarının daha iyi belirlenmesi ve postoperatif enteral ve parenteral beslenme ile mortalite ve morbidite arasında daha detaylı korelasyon çalışmalarının yapılması gerektiğini önermekteyiz.Anahtar Sözcükler: Konjenital duodenal obstrüksiyon, Yenidoğan, Yoğun bakım ABSTRACT Objective: Congenital duodenal obstructions consitute the majority of intestinal obstructions in the neonatal period. Although, morbidity and mortality have decreased significantly with preoperative and postoperative neonatal intensive care and appropriate nutritional therapies, it is seen that there are no studies comparing the interventions in duodenal obstructions over time. In our study, we aimed to examine the process of treatment of congenital duodenal...

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Section: Discussionunclassified

Section: Bulgularunclassified

Konjenital duodenal obstrüksiyonlarına klinik yaklaşım

Öztorun

Ertürk

Demir

et al. 2020

Turkish Journal of Pediatric Disease

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“…The presence of polyhydramnios was defined as an amniotic fluid index greater than 25 cm or a maximum vertical pocket exceeding 8 cm during pregnancy. At the level of the 'double bubble' sign, the maximum transverse diameter of the dilated duodenum (inner wall to inner wall) was measured to record the maximum dilatation of the duodenum [6]. (Fig.…”

Section: Methodsmentioning

confidence: 99%

“…CDO patients need to be operated on in the neonatal period after birth. The long-term survival rate has reached 86-90% with the development of CDO surgical operations in recent years [5,6]. Previous studies have shown that early diagnosis and surgery can reduce the incidence of metabolic disorders, duodenal obstruction and intestinal failure [1,7].…”

Section: Introductionmentioning

confidence: 99%

The application of prenatal ultrasound in the diagnosis of congenital duodenal obstruction

Yin

Tong

Ming-xiang

et al. 2020

BMC Pregnancy Childbirth

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Background: The purpose of this research is to summarize the prenatal ultrasound characteristics of congenital duodenal obstruction (CDO), especially in the diagnosis of duodenal diaphragm and annular pancreas. At present, few researchers have summarized the specific ultrasound features of duodenal diaphragm and annular pancreas. Methods: In this study, a retrospective analysis of 40 patients diagnosed with CDO between January 2016 and December 2019 was carried out. Data on the diagnosis, ultrasound images and outcomes of the patients were gathered, and the features of the patients were analyzed. Results: The results showed that there were 17 patients (42.5%) of congenital duodenal diaphragm, all with a 'rat tail' sign on the ultrasound images. Moreover, there were 4 patients (10.0%) of CDO caused by annular pancreas, all with a 'pliers' sign on the ultrasound images. We summarized the imaging features of the 'rat tail' sign and the 'pliers' sign. Conclusion: The main conclusion of this study was that the 'rat tail' sign could be used as an indirect ultrasound feature to diagnose duodenal diaphragm. The 'pliers' sign could be used as a direct ultrasound feature in the diagnosis of annular pancreas in CDO.

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“…[4][5][6] In CDO, the dilated stomach and first part of the duodenum appeared side by side across the midline of the upper fetal abdomen during prenatal sonography, which is known as the "double-bubble" sign. 7 This distinguishing feature has brought about great advances in the diagnosis since the later 1970s. 8 Delayed return of normal duodenal function necessitating a prolonged hospital stays may often follow the operative treatment of neonatal duodenal obstruction.…”

Section: Introductionmentioning

confidence: 99%

The relationship between sepsis and timing achievement of peristaltic function in congenital duodenal obstruction

Rahmaania

Sastiono

2019

NRJS

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Introduction.Intestinal obstruction has been shown to induce bacterial translocation and in turn, would be associated with an increased risk of sepsis. Such a condition would be affecting the achievement of peristaltic and ultimately increased morbidity and mortality. In addition, nosocomial infections that threaten neonates cause sepsis also will affect the achievement of a peristaltic. Thus, the aim of this study was to investigate the relationship between sepsis with timing achievement of peristaltic postoperatively. Method. This is a cross-sectional study with data obtained from medical records of patients with duodenal obstruction without congenital abnormalities (gastroschisis, omphalocele, and another intestinal atresia) that underwent operations in RSCM during the period of January 2010 to July 2016. Subjects were grouped into sepsis and without sepsis. The association between sepsis and timing achievement of peristaltic, and confounding variables (gestational age, birth weight, congenital abnormalities, conditions of hypoxia and electrolyte imbalance) were analyzed. Data analyzed using univariate, bivariate (Mann Whitney, Chi-Square or Fischer) and multivariate (linear regression) with the significance of <0.05. Results. The study enrolled a total of 31 subjects. Period to achieve peristaltic (median value) was 12.5 days in subjects with sepsis and 5 days in those without sepsis. Bivariate analysis between timing achievement of peristaltic were sepsis (p <0.0001), gestational age (p = 0.004) and hypoxic conditions (p = 0.02). The multivariate analysis showed an association between sepsis and timing achievement of peristaltic (p = 0.011, R 2 = 35.8%). Conclusion. In this study, sepsis was a major factor affecting the achievement of a peristaltic. The time difference to achieved peristaltic between sepsis and without sepsis was significance. Thus, it is necessary to control and prevent sepsis preoperatively and postoperatively that in turn, reducing morbidity and mortality.

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Association Between Prenatal Sonographic Findings of Duodenal Obstruction and Adverse Outcomes

Abstract: Prenatal sonographic findings of duodenal obstruction were not associated with adverse outcomes; however, they may be helpful for differentiating the cause of duodenal obstruction.

Cited by 19 publications

References 35 publications

Konjenital duodenal obstrüksiyonlarına klinik yaklaşım

Konjenital duodenal obstrüksiyonlarına klinik yaklaşım

The application of prenatal ultrasound in the diagnosis of congenital duodenal obstruction

The relationship between sepsis and timing achievement of peristaltic function in congenital duodenal obstruction

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