Abstract
Objective. For many years such diagnostic techniques as ultrasonography (U/S), contrast radiography (CR) and magnetic resonance imaging (MRI) have been successfully applied for the diagnosis of gastrointestinal diseases in children. Despite the long experience with U/S, CR and MRI for small intestine examinations, their diagnostic yield is yet not defined in the context of the short bowel syndrome considering the evaluation of advantages and disadvantages of these methods. In this regard, the purpose of our research was to define the role of each of these methods as a matter of assessing and monitoring patients’ condition as well as diagnosis of complications in patients with short bowel syndrome. Methods. To determine the opportunities of U/S, CR and MRI diagnostics for detection of malconditions in cases of short bowel syndrome we examined patients who had undergone ultrasound, CR and MRI of the intestinal tract as part of preoperative preparation for elongation of small intestine. In order to assess the diagnostic efficacy of aforementioned methods in the context of short bowel syndrome research results were compared with data obtained during surgery. Results. Ultrasonography (U/S) is considered to be the best screening technique for patients with SBS. Contrast radiography (CR) provides an opportunity to research the morphology of small intestine and its transport function quite thoroughly. Magnetic resonance imaging (MRI) is a method which allows one to give the best possible estimate of morphology of small intestine. Conclusion. U/S, CR and MRI of abdominal cavity organs are effective methods when it comes to the examination of small intestine in short bowel syndrome; each of these screening techniques has its own strengths and weaknesses. However, a proper combination of these methods should be applied, as it allows one to perform a comprehensive diagnosis of changes in short bowel syndrome and to take appropriate and timely actions regarding further patients’ treatment.
Highlights
Short bowel syndrome (SBS) is a severe life-threatening disease developing as a result of massive small bowel resection
During the first stage we studied the accuracy of U/S, magnetic resonance imaging (MRI) and contrast radiography (CR) diagnostical techniques for examining the length of the small intestine
Average accuracy was considered to be the result in cases, when the length of small intestine measured by radiodiagnostic methods coincided with the real data collected in the course of operation, whereby ± 25 cm deviation was tolerated
Summary
Short bowel syndrome (SBS) is a severe life-threatening disease developing as a result of massive small bowel resection. Intestinal failure is considered to be the main pathophysiological process in SBS [1,2,3]. The loss of functional activity of bowel in patients with SBS leads to compensatory development of intestinal adaptation, which includes a number of functional and structural changes of intestinal tract resulting in an increase of small intestine absorptive capacity [4, 5]. Some patients with SBS develop dilatation and intestinal dysmotility of small bowel, which in turn can lead to stagnation of intestinal contents, growth of pathogenic bacteria and decreased nutrient absorption. Can develop in the rest of small intestine after resection Stenosis, fistulas, inflammatory changes on the bowel wall, etc. can develop in the rest of small intestine after resection
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