Patel Parth, Shepp Kasey, Aribindi Haritha, Ibrahim Muaz
Final Pr. ID: Poster #: CR-011
The ingestions of magnetic foreign objects are a common occurrence in the pediatric population. The American Association of Poison Control has documented 95,700 incidents of foreign-body ingestion in the year 2011 alone with most cases occurring in children younger than 5 years of age. In this case, we present a two-year-old male who presented to the emergency department with a four-day history of bilious vomiting. Read More
Authors: Patel Parth , Shepp Kasey , Aribindi Haritha , Ibrahim Muaz
Keywords: jejuno-jejunal, fistula, small bowel obstruction
Final Pr. ID: Poster #: EDU-011
Educational goals: Highlight epidemiology, clinical presentation, radiographic findings, and treatment for common neonatal obstructions considered high in the intestinal tract including malrotation with midgut volvulus, duodenal atresia, duodenal web, annular pancreas, and proximal jejunal atresia.
Malrotation with midgut volvulus occurs when abnormally rotated and fixated small bowel twists about the superior mesenteric artery. This often presents with bilious vomiting in the first month of life and requires emergent surgical repair. Abdominal radiographs may be normal or show distention of the stomach and proximal duodenum with some distal bowel gas seen. An upper GI fluoroscopy exam (UGI) demonstrates a spiral/corkscrew sign or abrupt beaking with small bowel malrotation. Duodenal atresia is usually the result of incomplete recanalization of the duodenum. This presents at birth with abdominal distention and bilious or non-bilious vomiting depending on the segment of duodenum affected. Treatment is surgical resection of the atresia and reanastomosis. Classically on radiograph there is a double bubble sign, which may be seen on an antenatal ultrasound. Duodenal web results from an incomplete diaphragm/web within the lumen which causes intermittent complete or partial obstruction. There may be mild symptoms, or it may present similarly to duodenal atresia. It usually presents after the first week of life but may present in any age. Treatment is usually surgical or endoscopic resection. Abdomen radiographs may show mild proximal dilation or a double bubble sign distal bowel gas. UGI classically shows a windsock sign or duodenal dimple sign. Annular pancreas results from incomplete rotation of the ventral pancreatic bud leading to pancreatic tissue encasing the descending duodenum. The presentation and age of onset varies, in neonates and children it causes similar symptoms of duodenal obstruction. Cross-sectional imaging shows the duct draining the pancreatic head encircling the duodenum. Symptomatic cases of annular pancreas are usually treated surgically to alleviate obstructive symptoms. Jejunal atresia results from a vascular injury in utero causing one or more areas of stenosis/atresia. Proximal jejunal atresia presents with abdominal distention and bilious emesis. Abdominal radiographs classically show a triple bubble sign. Treatment is surgical resection of the involved segments of bowel.
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Authors: Burger Matthew , Lindsay Aaron
Keywords: Bowel obstruction, Neonatal
Final Pr. ID: Poster #: SCI-019
Paediatric fluoroscopy was recently incorporated into Singapore’s national FRCR aligned didactic curriculum, highlighting a growing need for structured and clinically relevant teaching in this domain. This study evaluates a novel, high-yield, case-based teaching model designed to enhance residents’ understanding, confidence, and exam preparedness in paediatric fluoroscopy. Read More
Authors: Tan Timothy Shao Ern
Keywords: Fluoroscopy, Paediatric Radiology, Neonatal Bowel Obstruction
Rajderkar Dhanashree, Sharma Priya, Verma Nupur
Final Pr. ID: Poster #: EDU-133
GI Emergencies and congenital malformation in the neonate are variable in their presentation and can be seen from the hypo-pharynx to the anus. The pediatric radiologist often plays a key role in diagnosis and planning of early surgical management. Read More
Authors: Rajderkar Dhanashree , Sharma Priya , Verma Nupur
Keywords: Congenital, GI malformations, Newborn bowel obstruction, New born GI emergencies, GI congenital emergencies
Llorens-salvador Roberto, Veiga-canuto Diana
Final Pr. ID: Poster #: EDU-037
Short Bowel Syndrome (SBS) is a significant cause of morbidity and mortality in neonates, resulting from a substantial reduction in functional small intestine.
It may arise from congenital anomalies or acquired conditions requiring extensive bowel resection.
This educational exhibit presents a review of the different pathologies potentially leading to SBS in neonates, to help radiologists offer an early and accurate diagnosis, critical to optimize clinical outcomes.
We review and illustrate conditions using multimodality imaging in:
1. Congenital causes of SBD:
Gastroschisis.
Bowel atresia.
Complicated meconium ileus.
Meconium peritonitis and meconium pseudocyst.
2. Acquired causes of SBS:
Malrotation and midgut volvulus.
Necrotizing enterocolitis.
Hirschsprung’s disease.
This study aims to underscore the essential role of perinatal imaging in the early detection, characterization, and management planning of both congenital and acquired etiologies leading to SBS in the neonatal population.
Emphasis is placed on the diagnostic utility of prenatal ultrasound and MRI and postnatal imaging techniques starting with plain radiography, contrast studies, and cross-sectional imaging in the neonatal period.
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Authors: Llorens-salvador Roberto , Veiga-canuto Diana
Keywords: Prenatal Imaging, Neonatal Bowel Obstruction, Perinatal
Rutten Caroline, Koenig Adriana, Zani Augusto, Daneman Alan
Final Pr. ID: Poster #: SCI-042
Intussusception in neonates and young infants is rare, with limited data to guide management. This study aims to characterize the presentation, management and outcomes of intussusception in infants ≤100 days of age. Read More
Authors: Rutten Caroline , Koenig Adriana , Zani Augusto , Daneman Alan
Keywords: Intussusception, Neonatal, Neonatal Bowel Obstruction
Saguintaah Magali, Taleb Arrada Ikram, Prodhomme Olivier, Bolivar Perrin Julie, David Stephanie, Sevette Nancy, Couture Alain, Baud Catherine
Final Pr. ID: Poster #: EDU-067
To review the imaging appearances of neonatal bowel obstruction, focusing on the sonographic findings.
To describe the etiologies and the indication for other imaging modalities
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Authors: Saguintaah Magali , Taleb Arrada Ikram , Prodhomme Olivier , Bolivar Perrin Julie , David Stephanie , Sevette Nancy , Couture Alain , Baud Catherine
Keywords: neonatal bowel obstruction, ultrasonography
Castro Denise, Silva Cecília, Paranhos Isabela, Lira Andréa, Fonseca Josélia, Ribeiro Rafaela
Final Pr. ID: Poster #: CR-045
A 10-year-old girl presented with 18-hour history of crampy periumbilical pain, associated with three episodes of non-bilious vomiting and anorexia over the past few days. She denied fever and had a normal bowel movement one day before admission. She had no medical history and was not on any medication. Her social development and school performance were both unremarkable. On physical examination, the abdomen was distended, tender in the periumbilical area, with normal bowel sounds and no peritoneal signs.
The abdominal radiograph showed air-fluid levels with distended small bowel loops and a large heterogeneous mass conforming to the shape of the stomach and a possible distended loop with mottled gas pattern in the mid pelvis, to the left of the midline. Six hours later, while in the hospital, the patient developed bilious vomiting and a computed tomography (CT) showed a mottled air-containing large mass within the stomach and a second smaller similar appearing mass within a segment of small bowel in the left lower quadrant, with diffuse distension of small bowel loops and multiple air-fluid levels proximal to it, in keeping with small bowel obstruction (SBO). The patient admitted to trichotillomania and trichophagia and a patch of alopecia was noted in the left parietal scalp. She was sent to the operating room where a supraumbilical vertical midline incision was made and a large obstructing trichobezoar completely filling the gastric lumen was removed through a transverse gastrotomy. The small bowel was inspected and a palpable, obstructing smaller trichobezoar was removed from the jejunum, approximately 1 meter from the pylorus.
Trichobezoars form after the ingestion of large amounts of hair, often over many years. Although trichotillomania affects about 1% of the population, only one third have trichophagia and just 1% of these individuals eat enough hair to require surgical intervention, making trichobezoars very uncommon in clinical practice. They are usually single and seen in the stomach, but in 5% of cases more then one bezoar is found. SBO occurs in fewer than 10% of patients with trichobezoar.
Plain radiographs are usually the initial imaging tool for diagnosis of SBO. CT can be helpful in determining the presence of obstruction in clinically suspected cases with equivocal plain radiographs, and determining the site and cause of obstruction, including trichobezoars.
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Authors: Castro Denise , Silva Cecília , Paranhos Isabela , Lira Andréa , Fonseca Josélia , Ribeiro Rafaela
Keywords: trichobezoar, small bowel obstruction, simultaneous, synchronous, bezoar