Accuracy of ultrasonography in detecting gastrointestinal tract obstructions in children; a prospective study in a tertiary referral hospital

Abstract

Aims: To examine the diagnostic accuracy of plain radiography, abdominal ultrasonography (US), and their combination in pediatric patients with suspected gastrointestinal (GI) tract obstruction.Material and methods: A cohort of 48 patients (age, 0-14 years, 27 boys) with clinical manifestations of GI tract obstruction underwent plain radiography and abdominal US examination. The final diagnoses were based on intraoperative findings, rectal biopsies (in Hirschsprung’s disease), or adequate follow-ups.Results: The GI tract obstruction was diagnosed in 40 patients. The sensitivity, specificity, positive predictive value and negative predictive value of plain radiography in diagnosing GI tract obstruction were 87.5%, 75.0%, 94.6%, and 54.6%, respectively. The corresponding values were 95%, 100%, 100%, and 80%, respectively when US was used alone; and 97.5%, 100%, 100% and 88.9%, respectively when radiography and US were used together. Except for two patients (one with Hirschsprung’s disease and the other with massive peritonitis), US detected the underlying causes of obstruction correctly in all patients.Conclusions: US is a highly sensitive and specific modality in diagnosing pediatric GI tract obstructions, as well as their causes. The combination of plain radiography and US further increase the diagnostic sensitivity and negative predictive value.