Keywords
Neonates
Ultrasonography
Diagnostic accuracy.
How to Cite
Abstract
Objective:
To validate the diagnostic performance of ultrasound in identifying intestinal malrotation among neonates using surgical findings as the gold standard.
Study Design:
Validation study
Place and Duration of Study:
Khyber Teaching Hospital, Department of Pediatric Surgery, in 4 months from 1st January 2025 to 30th April 2025.
Methodology:
This was a scientific project involving 151 infants with a median age of 1-28 days of age and were suspected of intestinal mal-rotation. The sample was recruited using non-probability consecutive sampling. Gray-scale and Doppler ultrasound was conducted to determine the orientation of mesenteric vessels and other sonographic features that are suggestive of malrotation. Confirmation was done using surgical findings. Parameters of diagnostic accuracy such as sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and overall diagnostic error have been determined.
Results:
In the 48 neonates, the ultrasound was able to detect intestinal malrotation correctly and exclude it correctly in 56 cases. The number of false-positive and false-negative was 40 and 7 respectively. Its sensitivity was 87.3, specificity 58.3, PPV was 54.5 and NPV was 88.9. The general percentage of diagnostic errors was 31.1%.
Conclusion:
The ultrasound is a sensitive and reliable screening modality in the exclusion of intestinal malrotation in neonates. Its negative predictive value is high thus it suits as a baseline imaging investigation, but positive results should be verified by additional diagnostic tests or surgical verification.