Non traumatic traumatic abdominal abdominal emergencies emergencies PDF
Preview Non traumatic traumatic abdominal abdominal emergencies emergencies
NNNNoooonnnn ttttrrrraaaauuuummmmaaaattttiiiicccc aaaabbbbddddoooommmmiiiinnnnaaaallll eeeemmmmeeeerrrrggggeeeennnncccciiiieeeessss Berna Oğuz MD Hacettepe University Faculty of Medicine Department of Radiology Pediatric Radiology Division Ankara, Turkey LLLLeeeeaaaarrrrnnnniiiinnnngggg oooobbbbjjjjeeeeccccttttiiiivvvveeeessss • Outline the variations of pathology that cause acute abdomen in children • Recognise imaging findings in the diagnosis of pediatric gastrointestinal system emergencies NNNNoooonnnn ttttrrrraaaauuuummmmaaaattttiiiicccc aaaaccccuuuutttteeee aaaabbbbddddoooommmmeeeennnn • Acute abdominal pain in children is one of the most common presentations at the emergency room. • There are numerous conditions that present with abdominal pain ranging from a very simple viral illness to a life-threatening surgical condition. • Accurate and rapid diagnosis of these conditions helps in reducing related complications. DDDDiiiiffffffffiiiiccccuuuullllttttyyyy iiiinnnn aaaarrrrrrrriiiivvvviiiinnnngggg aaaatttt tttthhhheeee ccccoooorrrrrrrreeeecccctttt ddddiiiiaaaaggggnnnnoooossssiiiissss • Nonspecific nature of symptoms • Atypical clinical presentations • Inability to give reliable history • Less reliable physical exam The radiologist, therefore, plays a key role in the initial care of abdominal emergencies in children The aim in the diagnosis is differentiating surgical versus nonsurgical conditions İİİİmmmmaaaaggggiiiinnnngggg aaaapppppppprrrrooooaaaacccchhhh • First imaging of abdominal emergencies in childhood is a radiograph of the abdomen • Followed by ultrasound • Further imaging depends on the results of these studies • GIS enema, CT or MRI in some cases Etiology of abdominal pain Newborn - infancy Childhood Adolescence • Gastroenteritis • Appendicitis • Appendicitis • İntussusception • Constipation • Ectopic pregnancy • Volvulus • Gastroenteritis • Biliary disease • İncarcerated hernia • Henoch-Schonlein Purpura • Gastroenteritis • Hirschsprung’s disease • Hemolytic uremia • İnflammatory bowel syndrome disease • Necrotising enterocolitis • İnflammatory bowel • Nephrolithiasis • Pyloric stenosis disease • Ovarian torsion • Urinary tract infection • Meckel’s diverticulum • Pancreatitis • Pancreatitis • PID • Pneumonia • UTI / pyelonephritis • Strep throat • Testicular torsion • Ulcer • Urinary tract infection NNNNeeeeccccrrrroooottttiiiissssiiiinnnngggg EEEEnnnntttteeeerrrrooooccccoooolllliiiittttiiiissss ((((NNNNEEEECCCC)))) • Most common, serious abdominal emergency in neonates • Usually in premature infants • Presents in the immediate newborn period • Acute fulminant disease associated with focal and/or diffuse ulceration and necrosis of the distal small intestine and the colon. NNNNeeeeccccrrrroooottttiiiissssiiiinnnngggg EEEEnnnntttteeeerrrrooooccccoooolllliiiittttiiiissss ((((NNNNEEEECCCC)))) Signs and symptoms • Abdominal distension • Abdominal tenderness • Feeding intolerance • Jaundice • Bilious vomiting • Bloody stools • Lethargy • Apneic episodes • Respiratory distress NNNNeeeeccccrrrroooottttiiiissssiiiinnnngggg EEEEnnnntttteeeerrrrooooccccoooolllliiiittttiiiissss ((((NNNNEEEECCCC)))) Radiography findings • Ileus- asymmetric pattern of bowel gas with varying degrees of dilatation • Pneumatosis intestinalis- air in bowel wall • Specific finding • 70-80% • Portal venous gas • Gasless abdomen • Pneumoperitoneum • Perforation finding
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