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Pediatric Surgery International

Published in:

01-12-2023 | Ultrasound | Original Article

Ultrasound assessment of abdominal adhesions in neonates: data over dogma for re-operative timing

Authors: Jack P. Vernamonti, Dimitra M. Lotakis, Heather Hartman, Danielle Dougherty, Marcus D. Jarboe

Published in: Pediatric Surgery International | Issue 1/2023

Abstract

Introduction

Neonatal abdominal reoperation is difficult and can be complicated by abdominal adhesions. Identifying patients who could safely undergo early reoperation would save TPN and central line days, decrease associated infection and liver injury, and NICU and hospital length of stay. We sought to determine if ultrasound (US) could accurately assess the location and severity of adhesions in neonates as an objective dynamic marker capable of informing reoperation timing.

Methods

After IRB approval, we conducted a prospective observational study including neonates undergoing abdominal operations. Patients received surgeon-performed US approximately every 2 weeks until reoperation or discharge. Adhesions were assessed in five zones: right upper quadrant (RUQ), right lower quadrant (RLQ), left upper quadrant (LUQ), left lower quadrant (LLQ) and peri-incision (INC).

Results

Over a 6-month study period, 16 neonates were enrolled. Median gestational age was 34 weeks at birth and median weight 2.2 kg. 6 underwent reoperation within initial NICU admission. At time of operation US correctly identified the absence or presence and severity of adhesions in: RUQ (3/3); RLQ (6/6); LUQ (4/5); LLQ (6/6); and INC (5/5).

Conclusion

US can identify location and severity of post-operative adhesions in neonates, potentially identifying patients who can safely undergo reoperation earlier than predetermined wait periods.

Level of evidence

IV.

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Title: Ultrasound assessment of abdominal adhesions in neonates: data over dogma for re-operative timing
Authors: Jack P. Vernamonti
Dimitra M. Lotakis
Heather Hartman
Danielle Dougherty
Marcus D. Jarboe
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Ultrasound
Care
Ultrasound
Published in: Pediatric Surgery International / Issue 1/2023
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-023-05430-0

2024 ASCO Annual Meeting

Springer Medicine

Ultrasound assessment of abdominal adhesions in neonates: data over dogma for re-operative timing

Abstract

Introduction

Methods

Results

Conclusion

Level of evidence

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Level of evidence

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