Role of Ultrasound in the Assessment of Pediatric Non Traumatic Gastrointestinal Emergencies

Abstract Background Ultrasound has become an important diagnostic imaging modality in the evaluation of the gastrointestinal tract of children adding a new perspective to the imaging of this body system. US observes gastrointestinal dynamics without exposure to ionizing radiation and allows detailed visualization of the mural layers of the bowel wall. Since children are unable to give reliable history, evaluation and establishing the correct diagnosis is challenging. Objectives To assess the role of Ultrasonography and its diagnostic efficacy in the evaluation of pediatric non-traumatic gastrointestinal emergencies. Patients and Methods A cross-sectional study of 64 pediatric patients presented with non- traumatic gastrointestinal emergencies. Results 64 patients were included in this study. 25 patients had acute appendicitis, 7 patients had complicated appendicitis, 23 patients had intussusception, 6 patients had hypertrophic pyloric stenosis and 3 patients had malrotation. Ultrasound sensitivity in the diagnosis of acute appendicitis was (90.6%), 22 out of 25 patients with acute appendicitis were correctly diagnosed by US. In the 3 other cases, US was negative for appendicitis which was confirmed by surgery. US sensitivity in the diagnosis of complicated appendicitis was (100%). As well as in the patients who had intussusception, hypertrophic pyloric stenosis and intestinal malrotation, US showed markedly high sensitivity reaching (100%). Establishing that Ultrasound has high diagnostic efficacy in assessing gastrointestinal emergencies as accuracy in diagnosing appendicitis was (90.6%) and accuracy in diagnosing intussusception, hypertrophic pyloric stenosis and intestinal malrotation was (100%). Conclusions Ultrasound is sufficient for the diagnosis of several gastrointestinal diseases that cause acute abdominal pain in pediatric patients helping to an accurate patient management in the emergency settings. Therefore, it is rapidly becoming an important imaging modality for the evaluation of acute abdominal pain, where satisfactory examination is often not achievable for the attending clinicians. Pediatric GIT non traumatic emergency conditions discussed are: Appendicitis, intussusception, hypertrophic pyloric stenosis and malrotation.