Learning objectives
Prompt diagnosis of an abdominal mass in a child is often a diagnostic challenge of imaging.
Prerequisites to a rational radiological approach are:
the knowledge of the patient’s age,
sex,
history and clinical findings
the proper use of different imaging modalities in the detection,
characterization and,
if necessary,
staging of abdominal masses.
A case series collected in our institution (Radiology Unit - Department of Medicine - University Hospital of Padova) is reported.
Background
Abdominal masses in children are often incidentally discovered by a parent,
palpated unexpectedly on routine physical examination or detected on abdominal imaging.
The underlying causes of such masses are several and can range from benign to malignant conditions including congenital anomalies,
trauma,
infections,
inflammatory diseases and neoplasms.
A methodical approach to an abdominal mass first of all contemplates patient-related information:
Age
Sex
History and clinical findings [1]
AGE: pediatric abdominal masses have characteristic age of onset.
Newborn: typical masses are represented by adrenal hemorrhage,
sacrococcygeal...
Findings and procedure details
The role of imaging in the diagnostic process can be differentiated in these steps:
Localization
Characterization
Staging (if necessary)
LOCALIZATION: the correct definition of the anatomical site of origin represents the first step in the abdominal mass evaluation.
Abdominal compartmentalization in intra-peritoneal,
retro-peritoneal and pelvic space can help in localizing a mass:
In case of intra-peritoneal mass distinguishing hepatic mass from other gastrointestinal origin (Fig.
1-6).
In retroperitoneal mass differentiating their renal or extra-renal origin (Fig.
7-13).
In case of pelvic mass indicating whether the...
Conclusion
A correct clinical overview of the pediatric patients and the proper use of different imaging modalitiesguide the diagnostic process through the wide spectrum of abdominal masses,
permitting the appropriate management.
Personal information
Silvia Karem Janet Flores Quispe,
MD,
Radiology Resident
Annachiara Cavaliere,
MD,
Radiology Resident
Monica Zuliani,
MD,
Radiologist
Tiziana Toffolutti,
MD,
Radiologist
Roberto Stramare,
Professor,
Radiologist
Radiology Uniti - Departement of Medicine - University of Padova
Via N.
Giustiniani,
2 - 35128,
Padova - Italy
[email protected]
[email protected]
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Treatment...