Learning objectives
The purpose of this exhibit is to review US appearance of the most common causes of non traumatic acute abdomen in pediatric patients and to give a practical approach,
showing different clinical cases.
Fig. 1
Background
Abdominal pain is a common cause of presentation in the Pediatric Emergency Department.
Ultrasound is the first line imaging method to evaluate abdominal pain.
The most fraquent causes of presentation in Pediatric Emergency Department are listed below:
Cry
Vomiting
Intestinal occlusion,
sub-occlusion,
diarrhea
Abdominal pain,
pelvic pain
Fever
Palpable mass
Trauma
Foreign bodies or substances ingestion
Articular pain
The aetiology of acute abdomen in pediatric population depends on the age.
In newborns:
acute gastroenteritis
intestinal occlusion (es: congenital megacolon)
intussusception
incarcerated hinguinal hernia
torsion of...
Imaging findings OR Procedure details
GASTROINTESTINAL TRACT PATHOLOGIES
Necrotizing enterocolitis (NEC)
Necrotizing enterocolitis is a serious abdominal disorder of premature neonates; it usually affects the terminal ileum and ascending colon.
Clynical symptoms include abdominal distension,
hematochezia,
apnea,
acidosis,
temperature instability,
lethargy.
Diagnosis is usually made on the basis of abdominal radiographs showing pneumatosis,
a thick-walled bowel,
free air and portal venous air.
Sonography may be useful when perforation and abscess formation are suspected.
Mural thickening of the terminal ileum and ascending colon may be shown.
Free intrabdominal fluid containing echogenic...
Conclusion
In the different age groups of children admitted to the pediatric ED,
acute abdomen recognizes various etiologies.
The most common causes of acute abdominal pain in the newborn babies are hypertrophic pyloric stenosis and intussusception.
In the younger children intussusception,
appendicitis and mesenteric adenitis.
In the older children inflammatory bowel disease and ovarian pathology are also included.
Ultrasound is an optimal diagnostic tool in the evaluation of children with acute abdomen allowing,
in most cases,
the visualization of the direct cause.
Even when the underlying...
References
Il dolore addominale acuto Gestione al Pronto Soccorso Rivista di Emergenza ed urgenza pediatricaAnno 3 - n.
1 - december 2008 -january 2009.
Il dolore addominale acuto Gestione al Pronto Soccorso Rivista di Emergenza ed urgenza pediatrica Anno 3 - n.
1 - december 2008 - january 2009.
Imaging of the acute abdomen in infants and children.
E.A.
Franken Jr,
Simon C.S.,
et al.
AJR: 153,
November 1989.
Ultrasonic "double track" sign in hypertrophic pyloric stenosis. Cohen HL et al.
J Ultrasound Med 1987 Mar;6(3):139-43....
Personal Information
V.
Miele1,
G.
L.
Buquicchio2,
V.
Di Giacomo2,
I.
Di Giampietro2,
S.
Ianniello2,
G.
Menichini1,
B.
Sessa1,
M.
Trinci3; 1Roma/IT,
2Rome/IT,
3Roma,
ITALY/IT
Mail to: Dr.ssa Vincenza Di Giacomo (
[email protected])