Ultrasound for the diagnosis of malrotation and volvulus in children and adolescents: a systematic review and meta-analysis.

Autor:	Nguyen, HaiThuy N., Kulkarni, Madhulika, Jose, Jisha, Sisson, Amy, Brandt, Mary L., Sammer, Marla B. K., Pammi, Mohan
Předmět:	VOLVULUS TEENAGERS ULTRASONIC imaging DIAGNOSIS COLOR Doppler ultrasonography CHILD patients RESEARCH META-analysis DIGESTIVE organ abnormalities CROSS-sectional method RESEARCH methodology MAGNETIC resonance imaging MEDICAL cooperation EVALUATION research COMPARATIVE studies RESEARCH funding
Zdroj:	Archives of Disease in Childhood; Dec2021, Vol. 106 Issue 12, p1171-1178, 8p
Abstrakt:	Context: Despite the advantages of ultrasound (US), upper gastrointestinal contrast series (UGI) remains the first-line diagnostic modality in the diagnosis of midgut malrotation and volvulus in children.Objective: Evaluate the diagnostic accuracy of US in the diagnosis of malrotation with or without volvulus in children and adolescents aged 0-21 years, compared with the reference standard (diagnosis by surgery, UGI, CT, MRI, and clinical follow-up individually or as a composite).Data Sources: We searched the electronic databases Ovid-MEDLINE, Embase, Scopus, CINAHL, and the Cochrane library in October 2019 and updated on 18 August 2020.Study Selection: Studies evaluating the diagnostic performance of US for diagnosis of midgut malrotation with or without volvulus in children (0-21 years).Data Extraction and Synthesis: The data were extracted independently by two authors and a bivariate model was used for synthesis.Results: Meta-analysis of 17 cohort or cross-sectional studies and 2257 participants estimated a summary sensitivity of 94% (95% CI 89% to 97%) and summary specificity of 100% (95% CI 97% to 100%) (moderate certainty evidence) for the use of US for the diagnosis of malrotation with or without midgut volvulus compared with the reference standard. Subgroup analysis and meta-regression revealed better diagnostic accuracy in malrotation not complicated by volvulus, in the neonatal population and enteric fluid administration before US.Conclusions: Moderate certainty evidence suggests excellent diagnostic accuracy and coupled with the advantages, a strong case exists for the use of abdominal US as the first-line diagnostic test for suspected midgut malrotation with or without volvulus in children and adolescents. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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