Imaging Non-traumatic Abdominal Emergencies in Pediatric Patients

393 Pages·2016·34.98 MB·English

by  Vittorio Miele

Imaging Non-traumatic
Abdominal Emergencies
in Pediatric Patients
Vittorio Miele
Margherita Trinci
Editors
123
Imaging Non-traumatic Abdominal
Emergencies in Pediatric Patients
Vittorio Miele (cid:129) Margherita T rinci
Editors
Imaging Non-traumatic
Abdominal Emergencies
in Pediatric Patients
Editors
Vittorio Miele Margherita Trinci
Department of Emergency Radiology Department of Emergency Radiology
S. Camillo Hospital S. Camillo Hospital
Rome Rome
Italy Italy
ISBN 978-3-319-41865-0 ISBN 978-3-319-41866-7 (eBook)
DOI 10.1007/978-3-319-41866-7
Library of Congress Control Number: 2016958305
© Springer International Publishing Switzerland 2016
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Dedicated to our Colleagues, who are true professionals, dear
friends, work and life mates
Foreword
P ediatric radiology, despite being recognized as an imaging subspecializa-
tion, in many countries does not have a strong presence in either undergradu-
ate or postgraduate radiology education programs.
T he aim of this book is to offer a reference text for radiologists and student
radiologists working within general imaging departments and highlights
unique aspects of pediatric radiology practice. In many cases, general radi-
ologists have inadequate contact with pediatric radiology during their course
of training. Pediatricians and surgeons, who wish to understand the indica-
tions, limitations, and clinical applications of imaging will also gain value
from this book. Usually, pediatricians lack not only the ability to interpret the
images, but also awareness about the importance of a fi nding for the next step
toward a diagnosis and thus for treatment.
The editors, Dr. V. Miele and Dr. M. Trinci, have been very effi cacious in
engaging several national specialists in the fi eld, to contribute to different
chapters and I would like to congratulate them for the quick and brilliant
harmonization of the editorial preparation of this second book on emergen-
cies. The fi rst one was I maging Trauma and Polytrauma in Pediatric Patients
(Springer, 2015).
The goal of this second book is to deliver again a comprehensive text on
the clinical application of radiology in a pediatric population. As in the fi rst
book, this goal is obtained by providing information on ways to enhance the
performance and interpretation of images, and to avoid technical and inter-
pretative errors: far greater emphasis is placed on radiation-dose reduction
techniques.
T he initial chapter provides exhaustive instruction for studying neonatal
acute abdomen, while reducing radiation exposure and presents hands-on
protocols for imaging. In the succeeding chapters, abnormal fi ndings are
described and illustrated for pediatric acute abdomen, neonatal and pediatric
GU emergencies, and critical issues in pediatric emergencies.
I mportantly, when writing this text, the authors tried to provide a descrip-
tion of all pediatric imaging techniques or provide answers to all imaging
dilemmas, even if many of these will be dependent upon local expertise,
radiographic equipment, and availability of alternative imaging modalities.
The diagnostic strategies used for children differ from those used for
adults in many points. Children and adolescents are not simply small adults;
they suffer from different diseases and require different treatments. The same
is true where imaging is concerned. The diagnostic approaches – using
vii
viii Foreword
identical diagnostic instruments – are different; the care prior to, during, and
following the examination differs from that of adults. One of the most impor-
tant aspects is radiation protection, as children are particularly sensitive to
ionizing radiation and, with their longer life expectancy, can also expect to
accumulate a higher dose from natural and artifi cial – above all medical –
causes. The latter increase the individual risk of malignant diseases. The best
radiation protection is the justifi cation of an examination employing ionizing
radiation (X-rays, CT scan). This is realized by establishing strict indications
and, on the other hand, if possible, by replacing ultrasonography or magnetic
resonance imaging for X-rays or CT. In addition to the aspect of radiation
protection, however, there is also a physical reason for the great value of
ultrasonography in pediatric radiology. High frequencies allow for high diag-
nostic quality but results in less penetration depth. Given the lesser body vol-
ume of children, higher frequencies can be used in them. This is one of the
reasons why ultrasonography is of greater value in pediatric radiology than in
adult radiology. Therefore, diagnostic fl ow charts produced from adult imag-
ing cannot be directly applied to pediatric radiology.
As in the fi rst highly successful book, the main emphasis is put on the
actual role of cross-sectional imaging methods in conjunction with standard
radiography. This volume covers our current knowledge and new visions into
the crucial role that radiological imaging plays in the appropriate manage-
ment of infants and children with acute abdominal diseases.
In summary, this book strives to update the current knowledge on non-
traumatic abdominal emergencies in children. Equipment continues to
improve; new technologies continue to develop; and the clinical applications
of radiology continue to evolve. It is necessary that radiologists meet the
challenge of applying these new technologies and applications to the care of
pediatric patients.
I am confi dent that this book will again inspire great interest among both
general and specialized pediatric radiologists, as well as among neonatolo-
gists, pediatricians, and pediatric surgeons.
Paolo Tomà
Diagnostic Imaging Department,
Children’s Hospital Bambino Gesù,
S. Onofrio Square , Rome , Italy
Contents
Part I Neonatal Acute Abdomen
1 Intestinal Stenosis and Atresia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Vittorio Miele, Claudia Lucia Piccolo, Valeria Saracco,
Maria Napoletano, Margherita Trinci, and Luca Brunese
2 Intestinal Malrotation and Volvulus . . . . . . . . . . . . . . . . . . . . . . . 31
Viola Valentini , Claudia Lucia Piccolo , Maria Napoletano ,
Rosanna Mamone , Massimo Zeccolini , and Vittorio Miele
3 Meconium Ileus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Margerita Trinci , Antonio Alessandro Pallottino ,
Claudia Lucia Piccolo , Francesca De Narda , Cinzia Orazi ,
and Vittorio Miele
4 Necrotizing Enterocolitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Margherita Trinci , Claudia Lucia Piccolo , Antonio Alessandro
Pallottino , Francesco Esposito , Massimo Zeccolini ,
and Vittorio Miele
5 Hirschsprung’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Domenico Barbuti
6 Complications of Neonatal Abdominal Devices
in Emergency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Riccardo Ferrari , Antonio Alessandro Pallottino ,
Claudia Lucia Piccolo , Maria Napoletano , Margherita Trinci ,
and Vittorio Miele
7 Biliary Atresia and Choledochal Cyst . . . . . . . . . . . . . . . . . . . . . . 95
Lidia Monti , Amato Infante , and Marco Salsano
Part II Pediatric Acute Abdomen
8 Hypertrophic Pyloric Stenosis (HPS) . . . . . . . . . . . . . . . . . . . . . 117
Margherita Trinci , Claudia Lucia Piccolo ,
Antonio Alessandro Pallottino , Michele Galluzzo ,
Eugenio Rossi , Massimo Zeccolini , and Vittorio Miele
ix
x Contents
9 Intestinal Intussusception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Michele Galluzzo , Francesco Gaudino , Riccardo Palliola ,
Eugenio Rossi , Massimo Zeccolini , and Margherita Trinci
10 Acute Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Grazia Loretta Buquicchio , Gavina Cuneo ,
Stefano Giannecchini , Caterina Pizzi , Carmelo Rende ,
and Margherita Trinci
11 Meckel’s Diverticulum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Maria Elena Latini , Sara Riccioni , Maria Napoletano ,
Nicola Recchia , and Michele Scialpi
Part III Neonatal and Pediatric GU Emergencies
12 Neonatal Adrenal Hemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Margherita Trinci, Caterina Maria Trinci,
Michele Galluzzo , Eugenio Rossi, Massimo Zeccolini ,
and Vittorio Miele
13 Hydrometrocolpos: Hematocolpos/Colpo-hematometra . . . . . . 193
Stefania Ianniello , Maria Gabriella Merola , Marinella Nanni ,
Cinzia Orazi , Paolo Schingo , and Margherita Trinci
14 Ovarian Torsion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
Marinella Nanni , Maria Gabriella Merola , Stefania Ianniello ,
Cinzia Orazi , Paolo Maria Schingo , and Margherita Trinci
15 Complications of Urachal Remnants . . . . . . . . . . . . . . . . . . . . . 229
Maria Elena Latini, Sara Riccioni, Nicola Recchia,
Maria Napoletano, and Michele Scialpi
16 Nephro-urolithiasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Francesca Pancrazi, Giulia Angelini, Laura Turturici,
Laura Tasciotti, Claudio Defi lippi, and Michele Tonerini
17 Acute Pyelonephritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Alessandra Scionti , Piercarlo Rossi , Pietro Gulino ,
Alessandro Semeraro , Claudio Defi lippi , and Michele Tonerini
18 Hydronephrosis and Pyonephrosis . . . . . . . . . . . . . . . . . . . . . . . 269
Silvia Lorenzi , Francesca Fanti , Giacomo Aringhieri ,
Marco Di Maurizio , Claudio Defi lippi , and Michele Tonerini
19 Posterior Urethral Valves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Cinzia Orazi , Antonio Maria Zaccara , Massimiliano Silveri ,
and Paolo Maria Schingo
20 Acute Scrotum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315
Riccardo Palliola , Antonio Alessandro Pallottino ,
Michele Galluzzo , Stefania Ianniello , Viola Valentini ,
and Margherita Trinci
Contents xi
Part IV Critical Issues in Pediatric Emergencies
21 Abdominal Neoplasm: Clinical Onset in Emergency
Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333
Barbara Sessa, Roberto Castellucci, Antonio Solazzo,
Eugenio Rossi, Massimo Zeccolini, and Sandro Sironi
22 MDCT and MRI Protocols in Pediatric Non-traumatic
Abdominal Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 365
Michele Scialpi , Maria Elena Latini , Sara Riccioni ,
Valeria Rondoni , Riccardo Torre , Lucia Mariotti ,
Alfredo D’Andrea , Raffaele Schiavone , and Lucia Manganaro
23 The Radioprotection of the Child in Emergency
Radiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377
Andrea Magistrellli
24 Informed Consent and Medicolegal Issues Related
to the Imaging of Pediatric Non-traumatic Emergencies . . . . . 397
Antonio Pinto, Giuseppe Lo Re, Fabio Pinto,
and Luigia Romano