Diagnostic Accuracy of Ultrasound for Detecting Gastric or Duodenal Ulcers in Pediatric Patients

Hosokawa, Takahiro; Tanami, Yutaka; Sato, Yumiko; Hara, Tomoko; Iwama, Itaru; Ishimaru, Tadayuki; Kawashima, Hiroshi; Oguma, Eiji

doi:10.1002/jum.15727

Cited by 5 publications

(5 citation statements)

References 25 publications

(52 reference statements)

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“…In case 3, inflammatory change was noted in the mesentery and high echogenicity around the mesentery was detected by US. This finding was reported to indicate inflammation [19]. In this case, however, US did not show a bowel wall thickness of >3 mm or loss of the wall stratification and VEO-IBD was diagnosed based on the endoscopic and pathological findings.…”

Section: Discussionmentioning

confidence: 56%

“…Although not specific to VEO-IBD, the following factors were important indicators of an IBD diagnosis: 1) bowel wall thickness and its stratification and 2) the distribution of inflammation [15][16][17][18]. Regarding the bowel wall thickness and its stratification, the cut-off value of bowel wall thickness was reported to be ≤3 mm (2-2.5 mm) [15][16][17][18][19][20][21][22][23][24]. Pathological inflammation mainly involves the mucosa and superficial submucosa in UC and all bowel wall layers from the mucosa to the serosa in CD [14].…”

Section: Discussionmentioning

confidence: 99%

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Role of ultrasound in the diagnosis of very early-onset inflammatory bowel disease in children: a report of three cases

et al. 2022

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Very early-onset inflammatory bowel disease (VEO-IBD) is defined as IBD onset before 6 years of age and some cases are caused by unique monogenic disorders that require specific treatments such as stem cell transplantation. We identified three children with VEO-IBD of whom two had monogenic disorders. In cases 1 and 2, ultrasound revealed isolated colonic distribution and the loss of wall stratification. In case 3, mesentery inflammation was evident. Bowel ultrasound showed variable findings due to differences in the inflammation distribution within the bowel. In order to diagnose VEO-IBD, sonographersshould carefully evaluate the intestinal wall thickness and stratification and the distribution of inflammation in the intestine and mesentery. These findings may aid the diagnosis of VEO-IBD.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Role of ultrasound in the diagnosis of very early-onset inflammatory bowel disease in children: a report of three cases

et al. 2022

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“…Transabdominal ultrasonography is an effective method for detecting peptic ulcer in low-weight children[ 20 ]. Therefore, sonographers should carefully evaluate indirect findings around the stomach or duodenum[ 21 ]. Fifteen cases were diagnosed by gastrointestinal CEUS, the diagnostic accuracy was 88.2% (15/17), and the coincidence rate was 95.3% (41/43).…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal contrast-enhanced ultrasonography for diagnosis and treatment of peptic ulcer in children

Zhang,

Xu,

et al. 2024

World J Gastroenterol

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BACKGROUND The detection rate of peptic ulcer in children is improving, with development of diagnostic procedures. Gastroscopy is the gold standard for the diagnosis of peptic ulcer, but it is an invasive procedure. Gastrointestinal contrast-enhanced ultrasonography (CEUS) has the advantages of being painless, noninvasive, nonradioactive, easy to use, and safe. AIM To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children. METHODS We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022. All children were examined by routine ultrasound, gastrointestinal CEUS, and gastroscopy. The pathological results of gastroscopy were taken as the gold standard. Routine ultrasonography was performed before gastrointestinal CEUS. Conventional ultrasound showed the thickness of the gastroduodenal wall, gastric peristalsis, and the adjacent organs and tissues around the abdominal cavity. Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall; the size, location and shape of the ulcer; gastric peristalsis; and adjacent organs and tissues around the abdominal cavity. The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS. All children received informed consent from their guardians for CEUS. This study was reviewed and approved by the hospital medical ethics committee. RESULTS Among the 43 children, 17 (15 male, 2 female) were diagnosed with peptic ulcer by gastroscopy. There were 26 children with nonpeptic ulcer. There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound. The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1% (34/43), which was significantly different from that of gastroscopy (P = 0.033). It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low. Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS. The diagnostic coincidence rate of peptic ulcer in children was 95.3% (41/43). There was no significant difference between CEUS and gastroscopy (P = 0.655). It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high. CONCLUSION Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children, and can be used as a preliminary examination method.

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“…By contrast, CT scan is less sensitive for diagnosing gastroduodenal ulcers ( 17 ). Hosokawa et al showed that not only direct findings including thickening of the gastrointestinal wall and ulcers but also indirect findings such as hyperintense fatty tissue around ulcers and lymph nodes are useful in pediatric patients with gastric and duodenal ulcers ( 14 ). In this study, 15 of 17 children had abnormal AUS findings that were correlated with the final diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, none of the previously mentioned procedures were performed in this study. AUS is a minimally invasive and simple examination and has a high detection rate for gastrointestinal lesions in children with a thin subcutaneous fat (14)(15)(16). By contrast, CT scan is less sensitive for diagnosing gastroduodenal ulcers (17).…”

Section: Discussionmentioning

confidence: 99%

Causes of Melena and Effective Examination Strategies in Children

et al. 2021

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Background and Aim: Melena, or tarry black stool, is not a rare symptom encountered in pediatric clinical practice, and the bleeding source varies from the upper gastrointestinal tract to the small intestine. Endoscopy is effective in identifying bleeding, but it does not always identify the source of bleeding. Endoscopic examination in children is commonly challenging, and there are no detailed reports about the causes of melena in children. This observational study aimed to validate the cause of melena in children and to investigate more effective and less burdensome examination methods.Methods: We retrospectively reviewed the clinical records of 55 patients who underwent examination for melena.Results: In this research, 38 patients had underlying diseases such as malignancy and severe mental and physical disorders. The bleeding source was identified in 39 patients. The most common final diagnosis was duodenal ulcer (n = 22), and the other diagnoses were gastric ulcer, esophagitis, and esophageal varices. The upper gastrointestinal tract was the most common source of bleeding (n = 34). In five patients, the bleeding source was the small intestine. Vomiting, abnormal abdominal ultrasonography findings, and a hemoglobin level of ≤ 3 g/dL than the lower normal limit were significant factors indicating that the bleeding source can be found on esophagogastroduodenoscopy.Conclusions: The upper gastrointestinal tract was the most common bleeding source of melena in children. As in adults, esophagogastroduodenoscopy is the primary endoscopic method of choice. Furthermore, small bowel capsule endoscopy may be useful in identifying the bleeding source in children without upper gastrointestinal lesions.

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Diagnostic Accuracy of Ultrasound for Detecting Gastric or Duodenal Ulcers in Pediatric Patients

Cited by 5 publications

References 25 publications

Role of ultrasound in the diagnosis of very early-onset inflammatory bowel disease in children: a report of three cases

Role of ultrasound in the diagnosis of very early-onset inflammatory bowel disease in children: a report of three cases

Gastrointestinal contrast-enhanced ultrasonography for diagnosis and treatment of peptic ulcer in children

Causes of Melena and Effective Examination Strategies in Children

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