Accuracy of radiographic estimation of small bowel dimensions in pediatric patients with short bowel syndrome

Background The decision to perform autologous intestinal lengthening in patients with short bowel syndrome (SBS) depends on total bowel length and the diameter and length of dilated segments. This study evaluated the accuracy of radiologic measurements of intestinal length and diameter. Methods Patients who underwent an intestinal lengthening procedure with preoperative upper gastrointestinal study (UGI) were identified from 10/2012 through 1/2015. Measurements of total length and diameters and lengths of dilated segments on UGI were compared to intraoperative measurements using Spearman's rank correlation coefficients and Bland-Altman plots. Results Fourteen patients underwent 15 lengthening procedures. Median age was 3.6 years. Most common causes of SBS were complicated gastroschisis (43%) and small bowel atresia (36%). Intra-operative bowel lengths prior to performing lengthening procedures ranged from 21 to 170 cm. The median measurements of radiographic and operative measurements (respectively) were total bowel lengths 77 cm and 69 cm (r = 0.93, p < 0.0001), maximum diameters 7.7 cm and 7 cm (r = 0.86, p = 0.001), and lengths of dilated segments 13 cm and 14 cm (r = 0.41, p = 0.36). Conclusions The correlation between UGI and operative measurements suggests that prediction of total bowel length and maximum diameter of dilation is accurate and can assist with operative planning.