Abstract
The acute abdomen is a common surgical problem in pediatrics for which there are many causes. The clinical and laboratory findings may be nonspecific, thus imaging procedures are often required for further evaluation. This chapter will outline the more common gastrointestinal (GI) causes of the acute abdomen in children and will review the role of various imaging procedures in this clinical setting.
-
1.
The plain abdominal radiograph still plays an important role in delineating the pattern of bowel gas, fluid levels and free air, as well as in detecting calcification and soft tissues masses. However, apart from the importance of detecting bowel obstruction and perforation, the findings on plain radiographs may often be nonspecific.
-
2.
GI contrast studies: In many situations (e.g. malrotation), upper GI series will be essential to provide information for appropriate management. In other clinical settings (e.g. congenital low bowel obstruction), the contrast enema is necessary, not only for diagnosis, but also for therapy (e.g. meconium plug syndrome and meconium ileus and intussusception).
-
3.
Sonography has, however, come to play an ever increasing role in the diagnosis of intra-abdominal pathology in children with acute abdomen (e.g. acute appendicitis, intussusception, Meckel’s diverticulum, biliary and pancreatic disease). Furthermore, sonography plays an important role in guiding therapeutic procedures such as the drainage of fluid collections and abscesses, biopsies and also intussusception reduction.
-
4.
Computed tomography (CT) is rarely required in the clinical setting of the acute abdomen, but is valuable if findings on sonography are equivocal or if there are complex fluid or abscess collections.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
Suggested Reading
Bramson RT, Blickman JG (1992) Perforation during hydrostatic reduction of intussuception: Proposed mechanism and review of the literature. J Pediatr Surg 27:589–591
Campbell J (1989) Contrast media in intussusception. Pediatr Radiol 19:293–296
Connolly B, Alton DJ, Ein SH, et al. (1995) Partially reduced intussusception: When are repeated delayed reduction attempts appropriate? Pediatr Radiol 25:104–107
Daneman A, Myers M, Shuckett B, Alton DJ (1997) Sonographic appearances of inverted Meckel diverticulum with intussusception. Pediatr Radiol 27:295–298
Daneman A, Alton DJ (1996) Intussusception: issues and controversies related to diagnosis and reduction. Radiol Clin N Am 34(4):743–756
Daneman A, Alton DJ, Ein S, et al. (1995) Perforation during attempted intussusception reduction in children — a comparison of perforation with barium and air. Pediatr Radiol 25:81–88
Guo JZ, MA XY, Zhou QH (1986) Results of air pressure enema reduction of intussusception: 6396 cases in 13 years. J Pediatr Surg 21:1201–1203
Katz ME, Siegel MJ, et al. (1987) The position and mobility of the duodenum in children. AJR Am J Roentgenol 148(5):947–951
Kim G, Daneman A, Alton DJ, Myers M, Sandler A, Superina R (1997) The appearance of inverted Meckel diverticulum with intussusception on air enema. Pediatr Radiol 27:647–650
Kirks D (1991) Practical pediatric imaging, 2nd edn. Little, Brown, Boston
Lang I, Daneman A, Cutz E, Hagen P, Shandling B (1997) Abdominal calcification in cystic fibrosis with meconium ileus: radiologic-pathologic correlation. Pediatr Radiol 27:523–527
Long F, Kramer SD, et al. (1996) Radiographic patterns of intestinal malrotation in children. Radiographics 16:547–556
Long F, Kramer SD, et al. (1996) Intestinal malrotation in children: Tutorial on radiographic diagnosis in difficult cases. Radiology 198:775–780
Miller SF, Landes AB, Dautenhahn LE, et al. (1995) Intussusception: Ability of fluoroscopic images obtained during air enemas to depict lead points and other abnormalities. Radiology 197:493–496
Ratcliffe JF, Fong S, Cheong I, et al. (1984) The plain abdominal film in intussusception. The accuracy and incidence of radiographic signs. Pediatr Radiol 22:110–111
Rohrschneider WK, Troger J (1995) Hydrostatic reduction of intussusception under US guidance. Pediatr Radiol 25:530–534
Shiels WE II, Maves CK, Hedlung GL, Kirks DR (1991) Air enema for diagnosis and reduction of intussusception. Clinical experience and pressure correlates. Radiology 181:169–172
Silverman FN, Kuhn J (1993) Caffey’s pediatric X-ray diagnosis, vol. 2, 9th edn. Mosby, St. Louis
Stein M, Alton DJ, Daneman A (1992) Pneumatic reduction of intussusception: 5-year experience. Radiology 183:681–684
Stringer DA (1989) Pediatric gastrointestinal imaging. BC Decker, Toronto
Swischuk LE (1989) Imaging of the newborn, infant and the young child, 3rd edn. Williams and Wilkins, Baltimore
Todani T, Sato Y, Watanabe Y, et al. (1990) Air reduction for intussusception in infancy and childhood: Ultrasonographic diagnosis and management without X-ray exposure. Z Kinder-chir 45:222–226
Wang G, Liu S (1988) Enema reduction of intussusception by hydrostatic pressure under ultrasound guidance. A report of 377 cases. J Pediatr Surg 23:814–818
Woo SK, Kim JS, Suh SJ, et al. (1992) Childhood intussusception: US-guided hydrostatic reduction. Radiology 182:77–80
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1999 Springer-Verlag Italia
About this paper
Cite this paper
Daneman, A. (1999). Imaging of the Pediatric Gastrointestinal Tract. In: von Schulthess, G.K., Zollikofer, C.L. (eds) Diseases of the Abdomen and Pelvis. Syllabus. Springer, Milano. https://doi.org/10.1007/978-88-470-2141-9_14
Download citation
DOI: https://doi.org/10.1007/978-88-470-2141-9_14
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-0058-2
Online ISBN: 978-88-470-2141-9
eBook Packages: Springer Book Archive