The paediatric acute abdomen PDF
Preview The paediatric acute abdomen
BMUS Summer School 2017 Martijn Verhagen Radiologist Fellow Paediatric Radiology at GOSH, London, UK Paediatric ultrasound: Something slightly different! • First choice imaging modality in paediatric radiology • CT and MRI only in selected cases • Different diseases, e.g.: • Intussusception • Malrotation and volvulus • Appendicitis • Different proportions • Smaller • Less fat! Paediatric ultrasound: Something slightly different! • First choice imaging modality in paediatric radiology • CT and MRI only in selected cases • Different diseases, e.g.: • Intussusception • Malrotation and volvulus • Appendicitis • Different proportions • Smaller • Less fat! The right approach • Patience • Involve the parents/guardians • Get them to help • It might make or break the examiation • Be gentle but diagnostic • Use warm gel • Keep thinking (goes for adult as well) • Use high frequency probes (it’s amazing) What to consider… Neonates Toddlers/Infants Children/Adolescents •Atresia (oesophagus, •Gastroenteritis •Appendicitis stomach, bowel) •Intussusception •Inflammatory bowel disease •Malrotation with volvulus •Malrotation and volvulus •IgA vasculitis •Hirschsprung disease •Appendicitis •Ovarium torsion •Meconium plug syndrome •Abdominal malignancy •Meckels diverticulum •Meconium ileus •Meckels diverticulum •Abdominal malignancy •Necrotising enterocolitis •Hemolytic uremic •Pancreatitis (NEC) syndrome •Distal intestinal obstruction syndrome Case 1 • GA 37 weeks • 2 days old • Bilious vomiting since 1 day • Abdominal distension • No fever Differential diagnosis? • Malrotation with volvulus • Proximal bowel obstruction • Duodenal/jejunal atresia/stenosis • Annular pancreas • Distal bowel obstruction • Meconium ileus • M. Hirshsprung • Atresia • Sepsis Volvulus or atresia?
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