ISSN:
2181-3906
2025
International scientific journal
«MODERN SCIENCE АND RESEARCH»
VOLUME 4 / ISSUE 6 / UIF:8.2 / MODERNSCIENCE.UZ
819
COMPREHENSIVE ULTRASONOGRAPHIC DIAGNOSIS OF ACUTE INTESTINAL
OBSTRUCTION IN CHILDREN
Orziqulova M. N.
Department of Medical Radiology
Aminov Kh.A.
Scientific Supervisor: Associate Professor
Department of Medical Radiology, TashPMI
https://doi.org/10.5281/zenodo.15686861
Abstract.
Acute intestinal obstruction in children is a serious clinical condition that
requires timely diagnosis to ensure effective management and improved prognosis.
Ultrasonography, due to its non-invasiveness and real-time imaging capabilities, has become
one of the most valuable diagnostic tools in pediatric practice. This study explores the role of
comprehensive ultrasonographic techniques in identifying different types of intestinal
obstruction among pediatric patients. Through clinical evaluation of 100 pediatric cases, this
paper demonstrates the diagnostic efficiency, interpretative criteria, and practical relevance of
sonographic findings. This work contributes to clinical best practices and advocates for
ultrasonography as a first-line diagnostic modality in children with suspected intestinal
obstruction.
Key
words:
Ultrasonography,
intestinal
obstruction,
pediatrics,
diagnosis,
intussusception, volvulus, acute abdomen, imaging, emergency medicine.
Introduction
Intestinal obstruction in pediatric patients represents a common and potentially life-
threatening emergency requiring rapid diagnosis and intervention. The clinical presentation often
includes abdominal pain, vomiting, abdominal distension, and altered bowel habits. While these
signs may suggest obstruction, imaging plays a pivotal role in confirming the diagnosis,
identifying the cause, and guiding management.
Historically, abdominal radiographs were the primary imaging modality. However,
limitations in sensitivity and specificity, coupled with concerns over radiation exposure, have led
to the increased adoption of ultrasonography. Pediatric patients, being more vulnerable to
radiation, benefit significantly from this non-invasive approach. The goal of this paper is to
systematically review and analyze the use of ultrasonography in diagnosing acute intestinal
obstruction, focusing on common etiologies such as intussusception, volvulus, hernias, and
meconium ileus.
Materials and Methods
The study was conducted prospectively over a span of 18 months in the pediatric surgical
unit of a tertiary healthcare institution. A total of 100 patients aged 1 month to 12 years
presented with clinical suspicion of acute intestinal obstruction. Inclusion criteria consisted of
signs and symptoms such as bilious vomiting, abdominal distension, absent bowel movements,
and severe colic. Exclusion criteria involved children with prior surgical interventions unrelated
to gastrointestinal conditions.
All patients underwent thorough clinical assessment followed by ultrasonographic
examination using high-frequency linear and convex transducers. Parameters evaluated included
bowel dilatation, wall thickness, peristalsis, presence of fluid, and pathognomonic signs such as
the 'target sign' and 'whirlpool sign'. Findings were corroborated with surgical exploration or
ISSN:
2181-3906
2025
International scientific journal
«MODERN SCIENCE АND RESEARCH»
VOLUME 4 / ISSUE 6 / UIF:8.2 / MODERNSCIENCE.UZ
820
further imaging (e.g., CT) when indicated. Statistical tools were employed to assess the
diagnostic sensitivity, specificity, positive predictive value, and accuracy.
Ultrasonographic Features of Different Types of Obstruction
Type
of
Obstruction
Ultrasound
Feature
Number of Cases
Confirmed
by
Surgery
Intussusception
Target
sign,
pseudokidney sign
35
33
Volvulus
Whirlpool
sign,
decreased perfusion
25
24
Hernia
Discontinuous wall,
non-reducibility
15
14
Meconium Ileus
Dilated
loops,
echogenic content
10
9
Others
Variable
15
13
Results and Discussion
Ultrasonography revealed positive findings in 97 out of 100 cases, with high sensitivity
for intussusception and volvulus. Among intussusception cases, the characteristic 'target sign'
was present in transverse views, while the 'pseudokidney sign' was observed in longitudinal
scans. Volvulus was identified through the 'whirlpool sign'—twisting of mesenteric vessels, a
critical indicator of ischemic risk. In cases of hernias, the discontinuity of the bowel wall and
absence
of
reducibility
on
compression
were
evident
sonographically.
Meconium ileus displayed unique features such as echogenic bowel contents and significant loop
distension. The sonographic accuracy was highest in diagnosing intussusception (94%) and
volvulus (92%). The findings were substantiated by intraoperative reports in 93% of the patients,
confirming ultrasonography’s reliability.
Comparative analysis with other imaging modalities showed that while CT offered better
anatomical detail, the associated radiation risk limits its application in pediatrics. Ultrasound, on
ISSN:
2181-3906
2025
International scientific journal
«MODERN SCIENCE АND RESEARCH»
VOLUME 4 / ISSUE 6 / UIF:8.2 / MODERNSCIENCE.UZ
821
the other hand, offered safe, repeatable, and fast evaluation. The portability of ultrasound
machines also made bedside assessments feasible in emergency settings. The study supports the
integration of ultrasound in initial diagnostic protocols for pediatric intestinal obstruction and
emphasizes the need for training clinicians in pediatric sonography.
Conclusions
The study validates comprehensive ultrasonography as an indispensable diagnostic
modality in pediatric intestinal obstruction. Given its non-invasive nature, diagnostic precision,
and real-time imaging capabilities, ultrasonography should be prioritized over radiographic
techniques wherever feasible. It plays a critical role not only in diagnosis but also in guiding
timely surgical interventions, thereby reducing complications. Further integration with artificial
intelligence-based tools could enhance interpretation accuracy and assist in triaging emergency
pediatric cases.
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