Learning objectives
To describe the normal ultrasonographic imaging features of the gastrointestinal (GI) tract.
To review the main inflammatory,
infectious and obstructive disorders of the gastrointestinal tract in the context of a pediatric emergency.
To illustrate the radiologic features of these conditions using ultrasonography (US).
To provide tips to avoid potential diagnostic errors.
Background
The abdominal pain is one of the most common complaints in the pediatric and neonatal emergency room.
Early diagnosis is a key tool to properly manage these patients.
The particularities of the images of the gastrointestinal tract and of the diseases common to the pediatric age group are usually a challenge to less experienced radiologists.
The US is a tool widely used to assess the gastrointestinal tract in children.
Its main advantages are the easy access and the radiation free environment.
Particularly in children,
their...
Findings and procedure details
NORMAL ANATOMY
The Gastrointestinal tract including the stomach,
small bowels and colon should be evaluated in all patients with acute abdomen.
The stomach has a normal wall thickness around 4 to 6 mm and it is better evaluated in the antrum full filled with water [1].Whereas the pylorus has a normal transverse diameter between 0.7-1.1cm ,
the length of pyloric canal is 1.0-1.3 cm and the thickness of the circular muscle is too thin to measure [2].
Normal bowel loops have a stratified pattern on...
Conclusion
The Advances in equipment technology and in ultrasonographic techniques allow the assessment of structures and their dynamic behavior that until recently were considered inaccessible to the method used,
increasing the diagnostic possibilities to the detriment of the methods classically used.
We can mention other advantages such as the availability and mobility of the ultrasound equipment,
besides cost and the possibility of repeating the exam without any side effects.
However,
such advances in ultrasound technique depend on a qualified professional with experience in handling pediatric patients,...
Personal information
Villas Bôas RM
Department of Radiology,
Clínica Boghos Boiadjian
Coelho AF
Department of Radiology,
Hospital Antonio Prudente
Pedrosa EFN
Department of Radiology,
Hospital Antonio Prudente
Silva VLL
Department of Radiology,
Hospital Antonio Prudente
Melo Filho AA
Department of Surgery,
Hospital Infantil Albert Sabin,
Fortaleza/Brasil
G D´Ippolito
Department of Radiology,
Escola Paulista de Medicina-UNIFESP
Lima da Rocha E
Department of Radiology,
Hospital Infantil Albert Sabin,
Fortaleza/Brasil
[email protected]
References
1.
Sporea,
Ioan,
and Alina Popescu.
"Ultrasound examination of the normal gastrointestinal tract." Medical ultrasonography 12.4 (2010): 349-352.
2.
Fonio,
Paolo,
et al.
"Ultrasonography (US) in the assessment of pediatric non traumatic gastrointestinal emergencies." Critical ultrasound journal 5.1 (2013): S12.
3.
Darge,
Kassa,
et al.
"Ultrasound of the bowel in children: how we do it." Pediatric radiology 40.4 (2010): 528-536.
4.
Biko,
David M.,
Daniel G.
Rosenbaum,
and Sudha A.
Anupindi.
"Ultrasound features of pediatric Crohn disease: a guide for case interpretation." Pediatric radiology 45.10...