Abdominal and Pelvic Masses

Abstract

The pediatrician frequently asks the pediatric radiologist to verify the existence of an abdominal or pelvic mass and to suggest possible diagnoses. The imaging approach to such problems varies, but these basic principles must be followed:

• The initial procedure should be a three-view abdominal series (Chap. 4).

• When there is only a question of a mass, the least invasive procedure should be done first.

• Once a mass has been established, the work-up is guided by the patient’s age, the location of the mass, and the symptoms (Table 6.1).

• The following priorities should be kept in mind: (a) Since barium interferes with ultrasound, radionuclide imaging, CT, and excretory urogram, any barium examination should follow these studies. (b) If both a barium enema and an upper GI series are necessary, the barium enema should be performed first because barium is more readily cleared from the colon.

• The pediatric radiologist is the best source of information as to how the imaging work-up should proceed.