Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, 50-1Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
Division of Neonatology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, 50-1Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
BMC Pediatr. 2021 Feb 19;21(1):91. doi: 10.1186/s12887-021-02554-x.
In neonatal intensive care unit (NICU) patients with intubation status, fluoroscopic evaluation for the bowel is limited. This study was to evaluate the utility of bedside upper gastrointestinal (UGI) series with delayed radiographs (DR) for assessing duodenojejunal junction (DJJ) and small bowel passage in NICU patients with nonspecific bowel ultrasonography and contrast enema findings.
We reviewed clinical and imaging data for bedside UGI with DR of NICU patients from 2014 to 2019. Five abdominal radiographs were obtained at fixed time intervals of immediately after, 1 min, 5 min, 1 h, and 2 h following the administration of 5 cc/kg isotonic water-soluble contrast agent via the nasogastric tube.
Twenty bedside UGI with DR were performed in 17 patients (weight range: 520-3620 g, age range: 0-4 months). Confidence identifying the DJJ was either good (n = 7) or equivocal (n = 8) at immediate or 1 min radiographs. The DJJ could not be evaluated in five from four delayed passage (including two meconium plug syndrome and one gastric volvulus) and one inadequate timing. There was only one case of intestinal malrotation, which was not detected on ultrasonography, but detected at the first UGI examination with good DJJ confidence.
Bedside UGI with DR can evaluate intestinal malrotation using immediate and 1 min delay and small bowel passage using 1 and 2 h delay images in NICU patients with nonspecific ultrasonographic and contrast enema findings. The majority with delayed contrast passages can have bowel pathology. Because of a small number of patients in this study, further studies with more infants are needed.
在新生儿重症监护病房（NICU）中，对于有插管状态的患者，进行透视评估肠道是有限的。本研究旨在评估床边上消化道（UGI）系列加延迟片（DR）在非特异性超声和对比灌肠检查结果的 NICU 患者中用于评估十二指肠胃（DJJ）和小肠通过的实用性。
我们回顾了 2014 年至 2019 年 NICU 患者床边 UGI 加 DR 的临床和影像学数据。在通过鼻胃管给予 5cc/kg 等渗水溶性对比剂后，立即以及 1 分钟、5 分钟、1 小时和 2 小时后，获得 5 张腹部 X 光片。
17 名患者（体重范围：520-3620g，年龄范围：0-4 个月）进行了 20 次床边 UGI 加 DR。在即时或 1 分钟的 X 光片上，DJJ 的识别置信度要么良好（n=7），要么不确定（n=8）。在 4 例延迟通过（包括 2 例胎粪栓综合征和 1 例胃扭转）和 1 例时机不当的情况下，无法评估 DJJ。只有 1 例肠旋转不良的病例，超声检查未发现，但在第一次 UGI 检查时发现，DJJ 信心良好。
在非特异性超声和对比灌肠检查结果的 NICU 患者中，床边 UGI 加 DR 可以使用即时和 1 分钟延迟评估肠旋转不良，使用 1 小时和 2 小时延迟图像评估小肠通过情况。大多数延迟对比通过的患者可能存在肠道病理。由于本研究患者数量较少，需要更多婴儿的进一步研究。
