|ECR 2019 / C-1157|
|Role of ultrasound in acute abdomen in children|
Dorland’s dictionary defines acute abdomen as an abdominal condition of abrupt onset usually associated with abdominal pain. Emergency surgical intervention is usually required. Abdominal pain in children is a frequent symptom among referrals to emergency departments. It accounts for 5%–10% of visits to the ED. It can be caused by a variety of conditions ranging from mild and self-limiting to life-threatening diseases. An early and accurate diagnosis results in more appropriate management and, subsequently, leads to better outcomes and lower risk of morbidity. The causes of the acute abdomen in children vary depending on the ages of the children and can be divided into diseases that can be treated with medical care and those in which emergency surgical intervention must be considered.
The most frequent cause of abdominal pain is gastroenteritis. While most of the emergency visits presenting with acute abdominal pain are self-limited and benign medical diagnoses, a surgical etiology may be present in up to 20%.3 In non-traumatic cases of an acute abdomen below 1 year of age, the most common surgical etiology was reported to be incarcerated inguinal hernia (45.1%), followed by intussusception (41.9%). These etiologies were uncommon in school-age and adolescent children. In children above 1 year of age, the most common causes of acute surgical diagnoses are acute appendicitis (64.0%), incarcerated hernia (7.5%), trauma (16.3%), intussusception (6.3%), intestinal obstruction (1.3%), and ovarian torsion (1.3%).
Imaging usually begins with a supine and horizontal beam radiograph. A chest radiograph is also commonly included to show extra-abdominal causes of acute abdominal pain such as pneumonia. Because of the noninvasive nature of sonography and its sensitivity in finding
the common lesions producing acute abdominal disease, it is often the next imaging procedure performed. Doppler application is helpful for assessing organ perfusion and diagnosing inflammation.
Thematically related posters
ECR 2019 / C-0579
Emergency radiology in full color: radio-surgical correlation in urgent abdominal pathology