Reduction in visceral slide is a good sign of underlying postoperative viscero-parietal adhesions in children

H. L. Tan, K. R. Shankar, N. Ade-Ajayi, M. Guelfand, E. M. Kiely, D. P. Drake, R. De Bruyn, K. McHugh, A. J. Smith, L. Morris, R. Gent

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background/Purpose: Viscera stuck to the anterior abdominal wall from previous surgery risk injury during laparoscopic surgery. A prospective study was conducted to determine if these adhesions are detectable on ultrasound scan by showing a reduction in the normal visceral slide. Methods: Patients undergoing laparoscopic procedure after a previous laparotomy underwent preoperative real-time ultrasound scan to observe if viscera slides freely under the abdominal wall. A reduction in slide was considered a positive sign of underlying adhesions. These findings were correlated with the operative findings. Results: Anterior abdominal wall scans were performed on 17 children. Reduced visceral slide was seen in 10. Visceroparietal adhesions were found in 9 of 10 patients. Visceral slide was reduced in a very localized area in 6 patients, and, in these, a loop of bowel (n = 3), liver and bowel (n = 2), or liver (n = 1) was adherent. In 4, reduced visceral slide was seen over a wide area. Extensive adhesions were found in 3 of 4. One renal transplant patient with peritonitis had a false-positive ultrasound scan. At laparotomy there were no adhesions. The peritonitis is thought to have prevented an adequate examination. Seven patients had normal visceral slide. Of these, 4 had no adhesions, but 3 children had flimsy omental adhesions. The sensitivity and specificity of visceral slide in predicting adhesions were 75% and 80%, respectively. Conclusions: Reduction in visceral slide is a good sign of underlying postoperative viscero-parietal adhesions. Ultrasonographic mapping of the abdominal wall may be useful in selecting an adhesion-free site for trocar insertion in children with previous operations requiring laparoscopic procedures.

Original languageEnglish
Pages (from-to)714-716
Number of pages3
JournalJournal of Pediatric Surgery
Volume38
Issue number5
DOIs
Publication statusPublished - 1 May 2003
Externally publishedYes

Fingerprint

Abdominal Wall
Viscera
Peritonitis
Laparotomy
Liver
Surgical Instruments
Laparoscopy
Prospective Studies
Transplants
Kidney
Sensitivity and Specificity
Wounds and Injuries

Keywords

  • Abdominal wall adhesions
  • Laparoscopy
  • Ultrasonography
  • Visceral slide

ASJC Scopus subject areas

  • Surgery

Cite this

Tan, H. L., Shankar, K. R., Ade-Ajayi, N., Guelfand, M., Kiely, E. M., Drake, D. P., ... Gent, R. (2003). Reduction in visceral slide is a good sign of underlying postoperative viscero-parietal adhesions in children. Journal of Pediatric Surgery, 38(5), 714-716. https://doi.org/10.1016/jpsu.2003.50190

Reduction in visceral slide is a good sign of underlying postoperative viscero-parietal adhesions in children. / Tan, H. L.; Shankar, K. R.; Ade-Ajayi, N.; Guelfand, M.; Kiely, E. M.; Drake, D. P.; De Bruyn, R.; McHugh, K.; Smith, A. J.; Morris, L.; Gent, R.

In: Journal of Pediatric Surgery, Vol. 38, No. 5, 01.05.2003, p. 714-716.

Research output: Contribution to journalArticle

Tan, HL, Shankar, KR, Ade-Ajayi, N, Guelfand, M, Kiely, EM, Drake, DP, De Bruyn, R, McHugh, K, Smith, AJ, Morris, L & Gent, R 2003, 'Reduction in visceral slide is a good sign of underlying postoperative viscero-parietal adhesions in children', Journal of Pediatric Surgery, vol. 38, no. 5, pp. 714-716. https://doi.org/10.1016/jpsu.2003.50190
Tan, H. L. ; Shankar, K. R. ; Ade-Ajayi, N. ; Guelfand, M. ; Kiely, E. M. ; Drake, D. P. ; De Bruyn, R. ; McHugh, K. ; Smith, A. J. ; Morris, L. ; Gent, R. / Reduction in visceral slide is a good sign of underlying postoperative viscero-parietal adhesions in children. In: Journal of Pediatric Surgery. 2003 ; Vol. 38, No. 5. pp. 714-716.
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abstract = "Background/Purpose: Viscera stuck to the anterior abdominal wall from previous surgery risk injury during laparoscopic surgery. A prospective study was conducted to determine if these adhesions are detectable on ultrasound scan by showing a reduction in the normal visceral slide. Methods: Patients undergoing laparoscopic procedure after a previous laparotomy underwent preoperative real-time ultrasound scan to observe if viscera slides freely under the abdominal wall. A reduction in slide was considered a positive sign of underlying adhesions. These findings were correlated with the operative findings. Results: Anterior abdominal wall scans were performed on 17 children. Reduced visceral slide was seen in 10. Visceroparietal adhesions were found in 9 of 10 patients. Visceral slide was reduced in a very localized area in 6 patients, and, in these, a loop of bowel (n = 3), liver and bowel (n = 2), or liver (n = 1) was adherent. In 4, reduced visceral slide was seen over a wide area. Extensive adhesions were found in 3 of 4. One renal transplant patient with peritonitis had a false-positive ultrasound scan. At laparotomy there were no adhesions. The peritonitis is thought to have prevented an adequate examination. Seven patients had normal visceral slide. Of these, 4 had no adhesions, but 3 children had flimsy omental adhesions. The sensitivity and specificity of visceral slide in predicting adhesions were 75{\%} and 80{\%}, respectively. Conclusions: Reduction in visceral slide is a good sign of underlying postoperative viscero-parietal adhesions. Ultrasonographic mapping of the abdominal wall may be useful in selecting an adhesion-free site for trocar insertion in children with previous operations requiring laparoscopic procedures.",
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AU - Shankar, K. R.

AU - Ade-Ajayi, N.

AU - Guelfand, M.

AU - Kiely, E. M.

AU - Drake, D. P.

AU - De Bruyn, R.

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AU - Smith, A. J.

AU - Morris, L.

AU - Gent, R.

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AB - Background/Purpose: Viscera stuck to the anterior abdominal wall from previous surgery risk injury during laparoscopic surgery. A prospective study was conducted to determine if these adhesions are detectable on ultrasound scan by showing a reduction in the normal visceral slide. Methods: Patients undergoing laparoscopic procedure after a previous laparotomy underwent preoperative real-time ultrasound scan to observe if viscera slides freely under the abdominal wall. A reduction in slide was considered a positive sign of underlying adhesions. These findings were correlated with the operative findings. Results: Anterior abdominal wall scans were performed on 17 children. Reduced visceral slide was seen in 10. Visceroparietal adhesions were found in 9 of 10 patients. Visceral slide was reduced in a very localized area in 6 patients, and, in these, a loop of bowel (n = 3), liver and bowel (n = 2), or liver (n = 1) was adherent. In 4, reduced visceral slide was seen over a wide area. Extensive adhesions were found in 3 of 4. One renal transplant patient with peritonitis had a false-positive ultrasound scan. At laparotomy there were no adhesions. The peritonitis is thought to have prevented an adequate examination. Seven patients had normal visceral slide. Of these, 4 had no adhesions, but 3 children had flimsy omental adhesions. The sensitivity and specificity of visceral slide in predicting adhesions were 75% and 80%, respectively. Conclusions: Reduction in visceral slide is a good sign of underlying postoperative viscero-parietal adhesions. Ultrasonographic mapping of the abdominal wall may be useful in selecting an adhesion-free site for trocar insertion in children with previous operations requiring laparoscopic procedures.

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