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Ultrasonographic Evaluation of Physiologic Free Intraperitoneal Fluid in Healthy Children: A Prospective
Anthony R Arredondo1, Matthew Wilkinson2, Richard B Barber3
1Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine, Houston, Texas, USA.
Insights
Physiologic free fluid (FF) in the pediatric abdomen is common, especially in the pelvis. This ultrasound study found FF in 16% of healthy children, more often in prepubertal patients.
Area of Science:
- Pediatric radiology
- Emergency medicine
- Point-of-care ultrasound (POCUS)
Background:
- Intraperitoneal free fluid (FF) detection is crucial in pediatric abdominal sonography, particularly for blunt trauma.
- Differentiating physiologic from pathologic FF presents a diagnostic challenge.
Purpose of the Study:
- To determine the prevalence, location, and volume of intraperitoneal FF in healthy pediatric patients.
- To investigate the relationship between FF and pubertal status and gender in children.
Main Methods:
- Utilized Point-of-Care Ultrasound (POCUS) with the Focused Assessment with Sonography in Trauma (FAST) examination.
- Evaluated 325 healthy children aged 1-17 years presenting with non-abdominal complaints.
Main Results:
- Intraperitoneal FF was detected in 16.0% of patients, exclusively in the pelvis.
- FF prevalence was similar between genders but higher in prepubertal children (20.0%) versus pubertal children (11.3%).
- 77% of children with FF had a volume less than 1 mL.
Conclusions:
- Physiologic FF, typically <1 mL in the pelvis, is a common finding in healthy pediatric patients.
- Gender does not influence FF prevalence, but prepubertal status is associated with a higher prevalence.
Objectives:
The detection of intraperitoneal free fluid (FF) is an important finding in the sonographic evaluation of the pediatric abdomen, especially in the context of blunt abdominal trauma. One specific challenge is differentiating physiologic from pathologic FF. The purpose of this study was to determine with ultrasound the prevalence, location, and volume of intraperitoneal FF in healthy pediatric patients and its relation to pubertal status and gender.
Methods:
Healthy children between the ages of 1 and 17 years who presented to the emergency department with non-abdominal complaints were evaluated for physiologic intra-abdominal fluid. Point-of-Care Ultrasound (POCUS) was performed, utilizing the Focused Assessment with Sonography in Trauma (FAST) examination.
Results:
A total of 325 pediatric patients were analyzed. Intraperitoneal FF was found in 52 children (16.0%, 95% CI: 12.0-20.0%). The pelvis was the only region where FF was located. The prevalence of FF was nearly equivalent between male and female children (15.4% vs 16.7%, P = .76). There was a higher prevalence of FF identified in the prepubertal subgroup compared to the pubertal group (20.0% vs 11.3%, P = .03). Seventy-seven percent of children with FF had a fluid volume of less than 1 mL.
Conclusions:
Physiologic FF of less than 1 mL within the pelvis is a common finding in the pediatric population. There was no difference in the rate of FF identified by gender, but there was a higher prevalence of FF among prepubertal children.
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