Pulsed Doppler sonography for the diagnosis of strangulation in small bowel obstruction.
OBJECTIVE
This study was undertaken to assess the usefulness of pulsed Doppler sonography (PDS) for the detection of strangulation in small bowel obstruction by evaluating the hemodynamics in the superior mesenteric artery (SMA).


METHODS
The authors performed PDS in 117 normal children: 22 children aged 0 to 1 months (group I), 27 children aged 1 to 12 months (group II), 36 children aged 1 to 6 years (group III), and 32 children aged 7 to 15 years (group IV). Patients included 25 with simple obstruction: 1 in group II, 10 in group III, and 14 in group IV; and 9 with strangulating obstruction: 2 in group I, 2 in group II, 3 in group III, and 2 in group IV. The authors measured the peak-systolic velocity, end-diastolic velocity (EDV), and mean average velocity and calculated the resistive index (RI).


RESULTS
The authors observed both a significant decrease in the EDV and increase in the RI for the SMA in strangulating obstruction compared with simple obstruction.


CONCLUSIONS
Analysis of the hemodynamics in the SMA using PDS is useful to differentiate strangulating obstruction from simple obstruction.
Okada
T
T
Department of Pediatric Surgery, Chiba University, School of Medicine, Chiba, Japan.
Yoshida
H
H
Iwai
J
J
Matsunaga
T
T
Ohtsuka
Y
Y
Kouchi
K
K
Tanabe
M
M
Ohnuma
N
N
D000293:Adolescent; D001783:Blood Flow Velocity; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007421:Intestine, Small / Q000098:blood supply* / Q000000981:diagnostic imaging; D007511:Ischemia / Q000000981:diagnostic imaging*; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging*; D018709:Statistics, Nonparametric; D018617:Ultrasonography, Doppler, Pulsed / Q000379:methods; D014655:Vascular Resistance