Bedside upper gastrointestinal series in critically ill low birth weight infants

Gopi K. Nayak, Terry L. Levin, Jessica Kurian Joseph, Anirudh Kohli, Steven H. Borenstein, Harold S. Goldman

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The upper gastrointestinal (UGI) series is the preferred method for the diagnosis of malrotation. A bedside UGI technique was developed at our institution for use in low birth weight, critically ill neonates to minimize the risks of transportation from the neonatal intensive care unit (NICU) such as hypothermia and dislodgement of support lines and tubes.

Objective: To determine the ability of a bedside UGI technique to identify the position of the duodenojejunal junction (DJJ) in low birth weight, critically ill infants in the NICU.

Materials and methods: We retrospectively reviewed bedside UGI examinations performed in premature infants weighing less than 1,500 g from 2008 to 2013 and correlated the findings with clinical data, imaging studies and surgical findings.

Results: Of 27 patients identified (weight range: 633–1,495 g), 21 (78%) bedside UGI series were diagnostic. Twenty of 27 cases (74%) demonstrated normal intestinal rotation. One case demonstrated malrotation with midgut volvulus, which was confirmed at surgery. In six cases (22%), the position of the DJJ could not be accurately determined. No cases of malrotation with midgut volvulus were missed. None of the patients with normal bedside UGI studies was found to have malrotation based on clinical follow-up (mean: 20 months), surgical findings or further imaging.

Conclusion: The bedside UGI is a useful technique to exclude malrotation in critically ill neonates and minimizes potential risks of transportation to the radiology suite. Pitfalls that may preclude a diagnostic examination include incorrect timing of radiographs, patient rotation, suboptimal enteric tube position and bowel distention. In cases of diagnostic uncertainty, a follow-up study should be performed.

Original languageEnglish (US)
Pages (from-to)1252-1257
Number of pages6
JournalPediatric Radiology
Volume44
Issue number10
DOIs
StatePublished - Sep 23 2014

Fingerprint

Low Birth Weight Infant
Critical Illness
Neonatal Intensive Care Units
Newborn Infant
Hypothermia
Radiology
Premature Infants
Uncertainty
Weights and Measures
Volvulus Of Midgut

Keywords

  • Low birth weight infants
  • Malrotation
  • Neonatal intensive care unit
  • Neonate
  • Upper gastrointestinal series

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Bedside upper gastrointestinal series in critically ill low birth weight infants. / Nayak, Gopi K.; Levin, Terry L.; Kurian Joseph, Jessica; Kohli, Anirudh; Borenstein, Steven H.; Goldman, Harold S.

In: Pediatric Radiology, Vol. 44, No. 10, 23.09.2014, p. 1252-1257.

Research output: Contribution to journalArticle

Nayak, Gopi K. ; Levin, Terry L. ; Kurian Joseph, Jessica ; Kohli, Anirudh ; Borenstein, Steven H. ; Goldman, Harold S. / Bedside upper gastrointestinal series in critically ill low birth weight infants. In: Pediatric Radiology. 2014 ; Vol. 44, No. 10. pp. 1252-1257.
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