Analysis Of Prenatal And Postpartum Value Of Ultrasonic Diagnosis Of Duodenal Obstruction

Part ? Analysis of the relationship between prenatal ultrasound findings and prognosis of congenital duodenal obstructionObjective The relationship between prenatal ultrasound performance and clinical prognosis in children with congenital duodenal obstruction(Congenital Duodenal Obstruction,CDO)was investigated by collecting the prenatal ultrasonographic features(the width of the gastric vesicles,the width of the duodenum,the amniotic fluid index),the clinical characteristics and the prognosis of the children.Materials and Methods A retrospective analysis was performed on the prenatal ultrasound findings and clinical outcomes of 75 children with CDO diagnosed prenatal ultrasound at the Third Affiliated Hospital of Zhengzhou University from June 2014 to June 2017 and confirmed by operation after birth.There were 42 males and 33 females.The first prenatal discovery of abnormal gestational weeks was 32.21 + 4.65 weeks,and premature delivery was found in 23 cases.The average gestational age at birth was 37.91±2.71 weeks,and the mean birth weight was 2.89±0.6Kg.According to the outcome of follow-up after birth,there were 22 cases in group A(adverse outcome group)and 53 cases in group B(no adverse outcome group).The poor outcome was the death or gastrointestinal related complications in follow-up Re-admission or reoperation.In group A,postoperative anastomotic leakage occurred in 7 cases,postoperative intestinal obstruction in 6 cases,postoperative infection in 7 cases,and death in 2 cases.Each case was followed up to 3 months after birth.Results 1.The width of gastric bubble and diameter of duodenum in group A were larger than those in group B,but the difference was not statistically significant(P>0.05).There was no significant difference in the amniotic fluid index and the first week of abnormal gestational weeks between the two groups.(P>0.05).2.The prenatal diameter of the stomach bubble,width of the duodenum and amniotic fluid index in both groups were positively correlated with gestational age,and the ratio of the diameter of the stomach bubble to duodenum was negatively correlated with gestational age.3.The gestational age and weight of birth in group A were less than that of group B.The incidence of other malformations associated with digestive tract in group A was greater than that in group B,and the differences were statistically significant(P<0.05).Conclusion 1.The prenatal ultrasound findings of children with CDO had no significant relationship with the prognosis of children.2.The width of the stomach bubble,the diameter of the duodenum,and the amniotic fluid index in prenatal fetal with CDO were increased with the increase of gestational age.3.Small gestational week,low body weight,or with other gastrointestinal malformations at birth can affect the prognosis of children.Part ? The value analysis of high frequency ultrasound in diagnosing duodenal obstructive disease in neonatesObjective By summarizing the sensitivity,specificity,positive predictive value and negative predictive value of high frequency ultrasound in the diagnosis of neonatal duodenal obstruction disease,to analyse the diagnostic value of ultrasonic diagnosis of duodenal obstructive diseases in neonates.Materials and Methods Preoperative gastrointestinal ultrasonography was performed on 130 neonates with clinically suspected or prenatal diagnosis of CDO from January 2015 to October 2017 at the Third Affiliated Hospital of Zhengzhou University.All children were confirmed by surgery,intraoperative diagnosis of annular pancreas,duodenal atresia or stricture,Congenital intestinal malrotation were 63 cases,28 cases,39 cases respectively.There were 71 males and 59 females,aged 10 minutes to 22 days,an average of 7.12± 1.25 days,admission weight of 1.45Kg-4.43 Kg,average weight of 2.98 ± 0.56 Kg.Among them,119 cases were performed prenatal ultrasound examination and 79 cases were diagnosed as CDO.Results 1.Ultrasound diagnosis of duodenal obstruction in 112 cases,the diagnostic rate was 86.1%.2.The overall etiological coincidence rate of high-frequency ultrasound diagnosis of CDO was 74.6%.The sensitivity of diagnosis of annular pancreatic,duodenal atresia or stenosis,and congenital malrotation were 68.2%,75.0%,and 84.6%,respectively.The specificities were 94.0%,89.2%,and 100%,the positive predictive values were 91.4%,65.6%,and 100%,and the negative predictive values were 75.9%,92.8%,and 93.8%,respectively.The diagnostic compliance rates were 81.5%,86.1%,and 95.3%,respectively.The Kappa values for consistency tests were 0.628,0.611,and 0.885,respectively.Conclusion 1.High-frequency ultrasound can be applied to the diagnosis of duodenal obstruction in neonates,with a high diagnostic value.2.High-frequency ultrasound is helpful for the etiological diagnosis of neonatal duodenal obstruction disease.