Page 388 - Abstract Book KONIKA 18

Pediatric Imaging

P-PI-036
Upper Gastrointestinal Series as an Imaging Standard
to Diagnose Midgut Malrotation with Volvulus: A Case Report

1
Yonita Aprilia ,Evita Karianni Bermanshah 2
1
2
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Intestinal malrotation is a congenital anomaly rotation of the midgut. It occurs during the first
trimester as the fetal gut undergoes a complex series of growth and development. Malrotation can lead
to a dangerous complication called volvulus. Objective To describe the upper gastrointestinal (GI) series
as an imaging standard to diagnose midgut malrotation. Case A 14-months old boy with cyclic vomiting
since 9 months ago suspected duodenal stenosis, was referred for an upper GI series. He had a history of
recurrent vomiting, abdominal pain and fever. He was diagnosed invagination in his third months old and
got the laparatomy procedure. After the surgery he still had a bilious vomiting. Distended abdomen was
encountered in physical examination. Upper GI series revealed distended gastric with abnormal location
of pyloric and duodenal jejuno junction with dilatation of duodenal pars 1-2, and slow passage through the
distal in accordance with midgut malrotation and gastric volvulus. This finding confirmed by laparotomy
exploration. Conclusion Cyclic vomiting with alarm sign should be evaluated further for organic problem.
In the suspicion of bowel obstruction upper GI series should be performed.
Keywords: midgut malrotation; volvulus; upper gastrointestinal series; bowel obstruction

P-PI-037
The Importance of Cranial Ultrasound
in Early Detection of Periventricular Leukomalacia: A Case Report

1
Ivens Zasanovaria Adhitama , Naela Fadhila , Evita Karianni Bermanshah 2
2
1
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
2
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Periventricular leukomalacia (PVL) is the most common ischemic brain injury in premature
infants. Diagnosing PVL is important because it will cause nonhemorrhagic neuropathological abnormality
in the cerebral white matter. A significant percentage of surviving premature infants may develop cerebral
palsy (CP) and neurodevelopmental impairment. Cranial ultrasound is the initial modality of choice for the
evaluation of PVL in premature infants. Objective To demonstrate the cranial ultrasound findings of PVL
in premature infant. Case A 28-weeks gestational age (1060 gram) newborn baby born via C-section from
36-years old mother with twin to twin pregnancy due to severe preeclampsia and oligohydramnios. There was
no history of maternal infection. Mother had routine prenatal care during pregnancy. Patient with respiratory
distress syndrome, required resuscitation and has been on a ventilator since born. The patient has seizures
that appear with desaturation and hypotension, acidosis, and recurrent neonatal sepsis. Cranial ultrasound
result showed increased echotexture in the periventricular white matter evolving into extensive cystic
lesions, that typical of PVL. Conclusion Diagnosing of PVL using brain imaging is critical for prognosis
determination. Long-term correlates of PVL include spastic diplegia and neurodevelopmental impairment.
Cranial ultrasound can be performed as a diagnostic procedure and prognostic. Cranial ultrasound provides
non-invasive, low-cost screening examination of the hemodynamically unstable neonate at the bedside and
no radiation exposure.
Keywords: periventricular leukomalacia; cranial ultrasound; premature infant

340 KONIKA XVIII Abstract Book