Journal List > J Korean Radiol Soc > v.16(2) > 1137526

Suh, Oh, and Park: Radiological evaluation of surgical emergencies in neonate

Abstract

Most pathologic conditions requiring emergent operation in neonate are congenital anomalies and delayeddiagnosis and associated anomaly are important factors which have contributed to the high mortality rate ofcongenital anomalies. To prevent this delay, early recognition of the danger signals, adequate roentagenologicexamination and accurate diagnosis should be made. Furthermore radiologists should be aware of developingmechanism, clinical manifestations and roentgenographic findings of those neonatal emergencies. 135 cases ofneonatal emergencies were analized at this point of view, which verified by surgery and pathologic examination atYonsei University College of Medicine, Severance Hospital since 1968. Embryology and characteristicroentgenographic pictures of each disease were discussed. The conclusions are as follows; 1. Most cases (110/135)presented intestinal obstruction. Imperforate anus(29 cases) was most common diseases which followed by infantilehypertrophic pyloric stenosis (25 cases), small bowel atresia and stenosis(18 cases), congenital megacolon(15cases) and esophageal atresia(14 cases). 2. Clinical Type and time of occurence of symtoms and signs were socharacteristic that those were helpful for differential diagnosis. 3. In infantil hypertrophic pyloric stenosis,confirmative diagnosis could be made in plain abdominal film, when "Caterpillar sign" was seen. 4. When smallbowel obstruction was suspected in plain abdominal film, barium enema examination was more helpful than upper G-Istudy. When microcolon was found, lower small bowel obstruction was highly suggested. 5. Diagnosis of midgutmalrotation was possible in larger cases (4/7). Upper G-I examination was more valuable than barium enema study,because duodenal obstruction due to L:add's band was common problem in neonate. 6. In neonatal period, diagnosisof aganglionosis could be made with the finding of barium stasis on 24-48 hours delay film, even though nodemonstration of transition segment in barium enema study. 7. Im perforate anus and esophageal atresia had highincidence of associated anomalies and co-existency. So skillful inspection should be made for discovery of thoseassociated anomalies.

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