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Imaging Acute Non-Traumatic Abdominal Pathologies in Pediatric Patients: A Pictorial Review
Lena Naffaa1, Andrew Barakat1, Amro Baassiri1
1Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon.
Insights
This review details imaging strategies for acute pediatric abdominal pain, emphasizing age-specific diagnoses like intussusception and appendicitis. It highlights ultrasound and CT roles while prioritizing radiation safety for effective diagnosis and treatment.
Area of Science:
- Pediatric Radiology
- Emergency Medicine
- Diagnostic Imaging
Background:
- Acute non-traumatic abdominal pathologies in children present unique diagnostic challenges based on age.
- Common surgical causes in young children (<2 years) include intussusception, pyloric stenosis, malrotation, and midgut volvulus.
- Older children share differential diagnoses with adults, such as acute appendicitis.
Purpose of the Study:
- To summarize the imaging approach for pediatric patients with acute abdominal pathologies in the emergency department.
- To illustrate how imaging guides diagnosis and treatment decisions.
- To emphasize radiation safety considerations in pediatric imaging.
Main Methods:
- Review of imaging modalities including ultrasound, fluoroscopy, and computed tomography (CT).
- Discussion of typical imaging findings for various pediatric abdominal pathologies.
- Emphasis on age-specific diagnostic considerations.
Main Results:
- Ultrasound and fluoroscopy are primary diagnostic tools, with contrast/air enemas offering therapeutic potential for intussusception.
- CT plays an increasing role in appendicitis and renal colic, particularly for complications, but radiation exposure is a concern.
- The article provides a pictorial review of common findings.
Conclusions:
- Imaging is crucial for diagnosing and managing acute abdominal conditions in pediatric emergency patients.
- Tailoring the imaging approach based on patient age and clinical presentation is essential.
- Balancing diagnostic accuracy with radiation safety is paramount in pediatric imaging.
Abstract:
The dilemma of acute non-traumatic abdominal pathologies in the pediatric population depends on the age of the patients and symptoms. Surgical etiologies in patients younger than 2 years of age include intussusception, pyloric stenosis, malrotation and midgut volvulus. In older patients, considerations become closer to differential etiologies in adults including acute appendicitis. Ultrasound and fluoroscopic examinations remain the mainstay for diagnosis that may even be therapeutic such as contrast/air enemas in intussusception reduction. There is an increasing role for CT in appendicitis and renal colic especially in assessing complications; however, it is less favored because it incurs radiation to the patient. This article summarizes the imaging approach to pediatric patients with acute abdominal pathologies presenting to the emergency department, and how imaging is instrumental in guiding diagnosis and treatment, with emphasis on radiation safety, in the context of providing typical imaging findings of each pathology in this pictorial review.
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