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Pediatric Surgery International

Erschienen in:

23.06.2020 | Original Article

Diagnostic performance and role of the contrast enema for low intestinal obstruction in neonates

verfasst von: Michael Baad, Jorge Delgado, Jillian S. Dayneka, Sudha A. Anupindi, Janet R. Reid

Erschienen in: Pediatric Surgery International | Ausgabe 9/2020

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Abstract

Purpose

We aim to evaluate the diagnostic performance and relationship between clinical characteristics, imaging findings, and final diagnosis for the neonatal contrast enema (CE).

Methods

Retrospective 10-year review of all neonatal CEs including imaging findings, clinical information, indication, and final diagnosis from discharge summaries, surgical reports, and pathology (reference standard). Two blinded pediatric radiologists reinterpreted 366 CEs for obstruction, microcolon, rectosigmoid index (RSI), serrations, meconium, ileal cut-off, transition zone, diagnosis, and level of confidence. CE diagnostic performance was calculated versus reference standard.

Results

Diagnoses included Hirschsprung disease (HD) (15.8%), small left colon syndrome (14.8%), small intestinal atresia/colonic atresia (SIA/CA) (12.6%), meconium ileus (MI) (4.4%), and normal (48.9%). CE had a moderate specificity (87.7%) and low sensitivity (65.5%) for HD; abnormal RSI and serrations showed high specificities (90.3%, 97.4%) but low sensitivities (46.6%, 17.2%). CE showed high specificity (97.4%) and low sensitivity (56.3%) for MI blinded to cystic fibrosis status. Microcolon was specific (96.6%) but not sensitive (68.8%) for MI. CE showed highest PPV (73.1%) (specificity 95.6%, sensitivity 82.6%) for SIA/CA. Microcolon with an abrupt cut-off was specific (99.1%) but not sensitive (41.3%) for atresias.

Conclusion

Neonatal CE demonstrates high specificities and low to moderate sensitivities across all diagnoses, with lowest performance in HD.

Clinical trial registration

None.

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Titel: Diagnostic performance and role of the contrast enema for low intestinal obstruction in neonates
verfasst von: Michael Baad
Jorge Delgado
Jillian S. Dayneka
Sudha A. Anupindi
Janet R. Reid
Publikationsdatum: 23.06.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 9/2020
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-020-04701-4

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Diagnostic performance and role of the contrast enema for low intestinal obstruction in neonates

Abstract

Purpose

Methods

Results

Conclusion

Clinical trial registration

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Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Clinical trial registration

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