Pulsed Doppler sonography for the diagnosis of strangulation in small bowel obstruction

Background/Purpose: This study was undertaken to assess the usefulness of p ulsed 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 ch ildren aged 1 to 6 years (group III), and 32 children aged 7 to 15 years (g roup IV). Patients included 25 with simple obstruction: 1 in group II, 10 i n 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 mea sured the peak-systolic velocity, end-diastolic velocity (EDV), and mean av erage velocity and calculated the resistive index (RI). Results: The authors observed both a significant decrease in the EDV and in crease in the RI for the SMA in strangulating obstruction compared with sim ple obstruction. Conclusion: Analysis of the hemodynamics in the SMA using PDS is useful to differentiate strangulating obstruction from simple obstruction. J Pediatr Surg 36:430-435. Copyright (C) 2001 by W.B. Saunders Company.