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Paediatric emergencies: non-traumatic abdominal emergencies
1Department of Radiology, Alder Hey Children's Hospital, Liverpool L12 2AP, UK.
Insights
Pediatric acute abdominal pain diagnosis relies on clinical exams and imaging. Ultrasound and abdominal radiographs are key for identifying conditions like intussusception and appendicitis in children.
Area of Science:
- Pediatric Radiology
- Pediatric Gastroenterology
Background:
- Acute abdominal pain is a frequent pediatric hospital presentation.
- Causes vary by age, surgical history, and include congenital issues, acquired diseases, and infections.
- Young children are often poor historians, necessitating thorough clinical examination and investigations.
Purpose of the Study:
- To detail the imaging approach for pediatric acute abdominal conditions.
- To highlight key imaging features of common pediatric abdominal pathologies.
Main Methods:
- Primary imaging includes abdominal radiography followed by ultrasound.
- Ordered review of abdominal radiographs is crucial for accurate diagnosis.
- Competency in pediatric abdominal ultrasound is emphasized.
Main Results:
- Common causes in infants include intussusception, appendicitis, and mesenteric adenitis.
- Older children may present with inflammatory bowel disease or ovarian pathology.
- Imaging findings guide further diagnostic steps.
Conclusions:
- Familiarity with common pediatric abdominal conditions and their imaging features is essential.
- Radiographs and ultrasound are primary tools for diagnosing pediatric abdominal emergencies.
- Accurate interpretation of imaging is vital for timely and appropriate management.
Abstract:
Presentation with acute abdominal pain or abdominal symptopathology is a very common cause of presentation of children to hospital. The causes are dependent in part on the age of the child, in part on the presence of previous surgery, and can be divided into those that relate to congenital abnormalities at whatever age they present, acquired disease and infection. Children, particularly young children are often poor historians, and therefore the clinical examination and the laboratory investigations are important in helping to come to a diagnosis. Primary imaging of abdominal emergencies in childhood is a radiograph of the abdomen, followed by ultrasound. Further imaging depends on the results of these studies. An ordered review of the abdomen radiograph is important if the salient features on X-ray are not to be missed. Practitioners should be competent with abdominal ultrasound in children and know where to seek the causes of disease, as these are different from those that are obtained in many instances in adults. Familiarity with the likely causes is important. The three commonest causes of acute abdominal pain in childhood are, in young infants, intussusception, appendicitis and mesenteric adenitis. In older children, inflammatory bowel disease and ovarian pathology are also included. This article details the approach to imaging and the salient features of some of the conditions.