Ultrasound anomalities in digestive tube patology on infants

Digestive tube ultrasound transabdominal examination on infants is possible because of the technical advances in medical hardware and the development of modern examination techniques and protocols.

Facing a patient with abdominal pain and dyspeptic syndrome, an ultrasound examination of the digestive tube from esogastric junction till rectus may be performed.

The studied pathology over a period of 10 years is: 100 children with acute gastroenteritis, 78 patients with chronic gastritis, 1 case with Menetrier gastritis, 30 children with ulcerous sufferings, 4 cases with hypertrophy pillory stenosis, 3 with acute peritonitis, 2 cases of intestinal tuberculosis, 10 children with intestinal occlusion, 39 patients with acute complicated and uncomplicated appendicitis, 5 children with abdominal tumours, 2 cases of Crohn disease, 3 children with intestinal diverticulitis, 1case of Hirschprung disease, 8 cases with mucoviscidosis, 4 children with gastroesofagian reflux.

For a complete diagnostic we have established the following digestive tube examination protocol:

• Thickness and smoothness of the wall with keeping of laminar structure (five concentric rings)

• Diameter and aspect of digestive lumen

• Content, quality and quantity of secretion, aeric content, excretion

• Peristaltic movement

• Presence of invasive components

• Pain sensations during examination on compression

• Vascularity

In inflammatory diseases of the digestive tube, the thickening of the intestinal wall over 3mm in distension and over 5mm without distension shows a characteristic sonographic sign, in transversal slice – „shoot the target“, and in longitudinal slice – „false kidney aspect“.

Sometimes the inflammatory disease of the digestive tube is associated with accumulation of fluid presenting a transonic image.

Colour Doppler ultrasound investigations, made on all patients, had brought us valuable information about the increased level of peripheral blood flow in inflamated areas. Triplex Doppler Ultrasonography identifies the neoformation vessels, the necrosis and calcification in malign tumours, with revealing local invasion elements which are signs of malign tumours and adenopathy.

Ultrasound sensitivity in apendicular diseases is 88% with a specificity of 92% and it can lead to an early diagnostic and the revealing of complications.

Ultrasound imagistic investigation is an indispensable method in the exploration of the digestive tube on infants.