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Ultrasonography: Applications in Pediatric Abdomen

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Abstract

Ultrasonography (US) is a valuable imaging tool for evaluation of different clinical conditions in children, in general and abdominal conditions, in particular. The interest in US derives primarily from the lack of ionizing radiation exposure, low cost, portability, real-time imaging and Doppler capabilities. In addition, US application requires no preparation or sedation, making it particularly attractive in the pediatric population. Because of these advantages, US has been adopted as the primary imaging tool for evaluation of a number of pediatric abdominal conditions that would have involved the use of ionising radiation in the past, e.g., pyloric stenosis, intussusception and various renal and bladder abnormalities, to name a few. Certain limitations, however, are inherent to US including large body habitus, excessive bowel gas, postoperative state and the learning curve. In addition, pediatric US is particularly challenging as the children are frequently unable to co-operate for breath holding and many of them are crying during the scanning. In the present review, the authors discuss the various applications of US in the evaluation of pediatric abdomen.

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Contributions

AKS: Manuscript editing, revision and final approval; PG: Wrote the manuscript and literature review; KSS: Manuscript editing and revision. AKS will act as guarantor for the paper.

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Authors and Affiliations

  1. Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India

    Akshay Kumar Saxena, Pankaj Gupta & Kushaljit Singh Sodhi

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  1. Akshay Kumar Saxena
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Correspondence to Akshay Kumar Saxena.

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Electronic supplementary material

Figure S1

Cholelithiasis. Transverse US image of the distended gallbladder shows a echogenic focus (arrow) with posterior acoustic shadowing (JPEG 48 kb)

Figure S2

Budd Chiari syndrome. Gray scale and Doppler US image of the hepatic veins shows echogenic lumen of the middle hepatic vein (arrow) with lack of color flow on color Doppler evaluation. Right hepatic vein shows normal color flow (JPEG 45 kb)

Figure S3

Pyogenic liver abscess. Transverse US image of the liver shows a well-defined cystic lesion with internal echogenic contents (arrow) and septations (short arrow) (JPEG 31 kb)

Figure S4

Splenomegaly. US image shows an enlarged heterogenous spleen in a case of lymphoma (JPEG 43 kb)

Figure S5

Focal splenic lesions. US image shows multiple hypoechoic lesions (arrows) in an enlarged spleen (JPEG 53 kb)

Figure S6

Pancreatitis. US image shows a bulky homogeneous pancreas (cursors) (JPEG 28 kb)

Figure S7

Meconium peritonitis (calcification). US image shows meconium pseudocyst (arrow). Image on the left shows dilated bowel loop with a focus of calcification (arrow) (JPEG 36 kb)

Figure S8

Duplication cysts. Axial US image of the upper abdomen shows a well-defined cystic lesion with multi-layered appearance of the wall in the upper abdomen (arrow) (JPEG 16 kb)

Figure S9

Appendicitis. Longitudinal and transverse US images of the right iliac fossa show a dilated tubular structure with thick wall (cursors) (JPEG 33 kb)

Figure S10

Ureteropelvic junction obstruction. Transverse US image of the right kidney shows markedly dilated renal pelvis (arrow) (JPEG 39 kb)

Figure S11

Perinephric urinoma. Longitudinal US images in a boy with posterior urethral valves show perinephric collection (cursors). The mildly hydronephrotic left kidney is displaced (arrows) (JPEG 43 kb)

Figure S12

Autosomal recessive polycystic kidney disease. Abdominal x-ray shows increased density in both flanks with displacement of bowel loops in the centre (A). Transverse US image shows bilateral smooth enlargement of kidneys with increase in echogenicity (B, arrows). High resolution ultrasound (7.5 MHz) shows linear radially arranged anechoic channels with intervening areas of raised echogenicity involving both cortex and medulla, suggestive of collecting duct ectasia with fibrosis (C). Liver showed raised periportal echogenicity (D, arrow) (JPEG 128 kb)

Figure S13

Autosomal dominant polycystic kidney disease (ADPKD). Longitudinal US image in a 5-y-old boy with family history of ADPKD shows a single cyst (arrow) in the upper pole of right kidney (JPEG 36 kb)

Figure S14

Adrenal hyperplasia. US image shows an enlarged left suprarenal gland (arrow). Left kidney is marked with short arrow (JPEG 21 kb)

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Saxena, A.K., Gupta, P. & Sodhi, K.S. Ultrasonography: Applications in Pediatric Abdomen. Indian J Pediatr 83, 553–564 (2016). https://doi.org/10.1007/s12098-015-1968-z

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