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SCIENTIFIC EXHIBITS |
1 From the Servicio de Radiodiagnóstico, Hospital Infantil "La Paz," Paseo de la Castellana 261, 28046 Madrid, Spain. Presented as a scientific exhibit at the 1997 RSNA scientific assembly. Received March 16, 1998; revision requested April 29 and final revision received September 15; accepted September 16. Address reprint requests to T.B.
Abstract
A wide spectrum of congenital anomalies may affect the upper gastrointestinal tract, including anomalies of the esophagus (eg, atresia, fistulas, webs, duplications, vascular rings), stomach (eg, congenital gastric outlet obstruction, duplications), and duodenum (eg, atresia, annular pancreas, duplications, malrotation). The evaluation of affected patients can require multiple imaging modalities for diagnosis and surgical planning. Radiography is often diagnostic and specific and can usually provide important clues to help determine the optimal diagnostic procedure. Neonates with complete gastric or upper intestinal obstruction do not usually require further radiologic evaluation after radiography: Barium studies are usually contraindicated, and complementary procedures (eg, ultrasound [US], computed tomography [CT]) are not usually helpful and may even delay surgery, resulting in death. Nevertheless, US has become important in the evaluation of the pediatric gastrointestinal tract and is being used in an increasing number of applications. CT and magnetic resonance imaging are unsuitable for general screening but provide superb anatomic detail and added diagnostic specificity. They are especially useful in demonstrating esophageal duplications and vascular rings as well as associated abnormalities. However, the decision to perform a given imaging examination should be considered carefully to avoid inconvenience or unnecessary radiation exposure to the patient or delays in surgical correction. Quality control programs should be in place to ensure safe, effective radiologic practice through use of up-to-date equipment and good imaging technique.
Index Terms: Duodenum, abnormalities, 73.143 • Duodenum, stenosis or obstruction, 73.143 • Esophagus, abnormalities, 71.141, 71.142 • Gastrointestinal tract, abnormalities, 71.14, 72.14, 73.14 • Stomach, abnormalities, 72.141, 72.143 • Stomach, stenosis or obstruction, 72.143
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