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Purulent pericarditis presenting as acute abdomen in children: abdominal imaging findings

L F Donnelly1, T R Kimball, L L Barr

  • 1Department of Radiology, Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.

Clinical Radiology
|October 29, 1999
PubMed

Insights

Purulent pericarditis in children can be fatal if untreated. This condition may present with abdominal symptoms and signs of sepsis, mimicking other serious illnesses.

Area of Science:

  • Pediatric Infectious Diseases
  • Cardiology
  • Radiology

Background:

  • Purulent pericarditis is a life-threatening infection.
  • Increasing antibiotic resistance contributes to severe pediatric bacterial infections.
  • Early diagnosis is critical for favorable outcomes.

Observation:

  • Two pediatric cases of purulent pericarditis presented with acute abdominal distention and sepsis.
  • Imaging (CT and ultrasound) revealed periportal edema, gallbladder wall thickening, and ascites.
  • These abdominal findings were secondary to right heart failure caused by cardiac tamponade.

Findings:

  • Children with purulent pericarditis may not show cardiomegaly on chest radiographs.
  • Abdominal symptoms can be the primary presentation in pediatric purulent pericarditis.
  • Abdominal imaging can reveal signs of right-sided heart failure due to cardiac tamponade.

Implications:

  • Radiologists must consider purulent pericarditis in children presenting with sepsis and abdominal symptoms.
  • Awareness of atypical presentations can improve diagnostic accuracy.
  • Prompt recognition and treatment of purulent pericarditis are essential to prevent mortality.

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