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PEO 5006 Appendicitis: US imaging in children
Ultrasound
S86
in Medicine
and Biology
PEO 5005
A 3-day-old neonate presented with bilious vomiting and abdominal distension. Ultrasound (US) showed abnormal position of the superior mesenteric vein (SMV) and superior mesenteric artery (SMA) at the pancreatic head (SMV rotation sign). Scans at the upper abdomen visualized a helical structure consisting of the intestine and mesenteric vessels (whirlpool sign), which were recorded on video. US suggested midgut volvulus with malrotation. Upper gastrointestinal (UGl) and barium enema studies (BE) were not performed. A laparotomy revealed midgut malrotation with volvulus without necrosis of the intestines. Real-time US is very useful in diagnosing midgut volvulus in a patient with malrotation.
PEO5006
1, 1997
SPECTRUM -Authors. Dannef Hospital
OF PANCREATIC IN CHILDREN
LESIONS
M6nica M.D, Casalis Claudia M.D, Lipsich Jose M.D Moguillansky Silvia M.D, Goldberg Albert0 M.D de Pediatria ‘J.P.Garrahan” - Buenos Aires- Argentina
US IMAGING IN CHILDREN
LIVER DISEASE IN CHILDREN WITH CYSTIC FIBROSIS: A SONO-BIOCHEMICAL COMPARISON IN 195 PATIENTS
Authors, E. M.D., Garcia L. M.D, Drajer M. M.D, Crocci Felipe L..M.D, Goldberg Albert0 M.D de Pediatria
“J.P.Garrahan”
- Buenos
Aires
M. M.D
-Argentina
-
We present a prospective study of 71 patients with appendicitis, with surgically and pathologically proved, the 64.5% showed pathologic US, from which: pathological apendix (66%) (focal,apendicolitiths, fluid-filled lumen,), appendicaal abscesses (13.3%) (loss of echogenic submucosa layer), intrabdominal fluid (13.3%), periapendicular mass (5%). The technique for evaluating patients wit supected appendicitis was the gradedcompression method ( Puylaen techniq). A transducer 5 or 7.5 MHz was used. Acute appendicitis is the most common cause of emergency abdominal surgery in children a great proportion have atipical findings, caused for an aberrant location of the appendix, in pelvis or retrocecal. Therefore, there were definite correlations between US patterns and pathologic severity of the disease. When US does not identify findings of acute appendicitis we must look for other specific diagnosis: gynecologic disease, mesenteric adenitis, tiphlitis.
-
Thirty nine children with pancreatic disorders were reviewed over a six years period ( from January 1991 to December 1996) to assess the value of US in diagnosis, follow up and as a guide for percutaneous procedures. Traumatic: 12 patients (30.76%); insulinoma, 9 (23%); metastatic lesions, 4 (10.25%); recurrent pancreatitis in 2 biliary malformations (5.12%); other causes ( viral, ascaris, drugs and associated with genetic diseases), 12 (30.7%). Pancreatic disorders are probably more common in childhood than was previously thought. A child’s thin body habitus with generally low body fat content and a relatively large left hepatic lobe are largely responsible for a higher frequency of satisfactory examinations in children than in adults. Sonography is as the radiological procedure of choice in the diagnosis, follow up and as a guide for interventional procedures of the pancreas.
PE05008
APPENDICITIS:
Hospital
23, Supplement
PE05007
ULTRASONOGRAPHIC DIAGNOSIS OF MIDGUT VOLVULUS IN A PATIENT WlTH MALROTATION: A CASE REPORT Makoto Ueda’, Hirotsugu Matsumoto*, Kiyoshi Ohshiro3 ‘Department of Surgery, Okinawa Nanbu Hospital, Okinawa, Japan. Departments of ‘Surgery and 3Radiology, Okinawa Chubu Hospital, Okinawa, Japan.
Dardanelli
Volume
H. Patriauin’, C. Lenaert.?, L. Smith*, G. Perreault’, A. Grignon’, D. Filiatrault’, J. Boisvert’ et al. Departments of Medical Imaging’ and Gastroenterology2, Hopital Sainte-Justine, Montreal, Quebec, Canada Obiectives: Biliary cirrhosis complicating cystic fibrosis (CF) is often clinically silent. Sonography is being used to screen affected children. We wished to determine if abnormal liver architecture at sonography is related to abnormal function as measured by biochemical tests. Methods: Liver size and architecture, signs of portal hypertension (PHT), as well as semm transaminases (AST ALT) and glutamyl nansferase (YGT) were evaluated on the same day. &I&: Of 195 children (112 boys and 83 girls, mean age 8.5 years), 38 with abnormal liver sonograms had a higher incidence of functional abnormalities than those with normal architecture (63% vs lo%, p < 0.0001). The commonest abnormalities associated with abnormal function were signs of HTP (lOO%), of cirrhosis (high attenuation, nodules) (77%), and of steatosis (hyperechogenic livers) (50%). Conclusion: There is a correlation between sonographically abnormal liver architecture (especially signs of HTP and cirrhosis) and 3 tests of liver function (YGT, AST, and ALT). Together, these tests may be appropriate for screening children with CF for liver disease.
S86
in Medicine
and Biology
PEO 5005
A 3-day-old neonate presented with bilious vomiting and abdominal distension. Ultrasound (US) showed abnormal position of the superior mesenteric vein (SMV) and superior mesenteric artery (SMA) at the pancreatic head (SMV rotation sign). Scans at the upper abdomen visualized a helical structure consisting of the intestine and mesenteric vessels (whirlpool sign), which were recorded on video. US suggested midgut volvulus with malrotation. Upper gastrointestinal (UGl) and barium enema studies (BE) were not performed. A laparotomy revealed midgut malrotation with volvulus without necrosis of the intestines. Real-time US is very useful in diagnosing midgut volvulus in a patient with malrotation.
PEO5006
1, 1997
SPECTRUM -Authors. Dannef Hospital
OF PANCREATIC IN CHILDREN
LESIONS
M6nica M.D, Casalis Claudia M.D, Lipsich Jose M.D Moguillansky Silvia M.D, Goldberg Albert0 M.D de Pediatria ‘J.P.Garrahan” - Buenos Aires- Argentina
US IMAGING IN CHILDREN
LIVER DISEASE IN CHILDREN WITH CYSTIC FIBROSIS: A SONO-BIOCHEMICAL COMPARISON IN 195 PATIENTS
Authors, E. M.D., Garcia L. M.D, Drajer M. M.D, Crocci Felipe L..M.D, Goldberg Albert0 M.D de Pediatria
“J.P.Garrahan”
- Buenos
Aires
M. M.D
-Argentina
-
We present a prospective study of 71 patients with appendicitis, with surgically and pathologically proved, the 64.5% showed pathologic US, from which: pathological apendix (66%) (focal,apendicolitiths, fluid-filled lumen,), appendicaal abscesses (13.3%) (loss of echogenic submucosa layer), intrabdominal fluid (13.3%), periapendicular mass (5%). The technique for evaluating patients wit supected appendicitis was the gradedcompression method ( Puylaen techniq). A transducer 5 or 7.5 MHz was used. Acute appendicitis is the most common cause of emergency abdominal surgery in children a great proportion have atipical findings, caused for an aberrant location of the appendix, in pelvis or retrocecal. Therefore, there were definite correlations between US patterns and pathologic severity of the disease. When US does not identify findings of acute appendicitis we must look for other specific diagnosis: gynecologic disease, mesenteric adenitis, tiphlitis.
-
Thirty nine children with pancreatic disorders were reviewed over a six years period ( from January 1991 to December 1996) to assess the value of US in diagnosis, follow up and as a guide for percutaneous procedures. Traumatic: 12 patients (30.76%); insulinoma, 9 (23%); metastatic lesions, 4 (10.25%); recurrent pancreatitis in 2 biliary malformations (5.12%); other causes ( viral, ascaris, drugs and associated with genetic diseases), 12 (30.7%). Pancreatic disorders are probably more common in childhood than was previously thought. A child’s thin body habitus with generally low body fat content and a relatively large left hepatic lobe are largely responsible for a higher frequency of satisfactory examinations in children than in adults. Sonography is as the radiological procedure of choice in the diagnosis, follow up and as a guide for interventional procedures of the pancreas.
PE05008
APPENDICITIS:
Hospital
23, Supplement
PE05007
ULTRASONOGRAPHIC DIAGNOSIS OF MIDGUT VOLVULUS IN A PATIENT WlTH MALROTATION: A CASE REPORT Makoto Ueda’, Hirotsugu Matsumoto*, Kiyoshi Ohshiro3 ‘Department of Surgery, Okinawa Nanbu Hospital, Okinawa, Japan. Departments of ‘Surgery and 3Radiology, Okinawa Chubu Hospital, Okinawa, Japan.
Dardanelli
Volume
H. Patriauin’, C. Lenaert.?, L. Smith*, G. Perreault’, A. Grignon’, D. Filiatrault’, J. Boisvert’ et al. Departments of Medical Imaging’ and Gastroenterology2, Hopital Sainte-Justine, Montreal, Quebec, Canada Obiectives: Biliary cirrhosis complicating cystic fibrosis (CF) is often clinically silent. Sonography is being used to screen affected children. We wished to determine if abnormal liver architecture at sonography is related to abnormal function as measured by biochemical tests. Methods: Liver size and architecture, signs of portal hypertension (PHT), as well as semm transaminases (AST ALT) and glutamyl nansferase (YGT) were evaluated on the same day. &I&: Of 195 children (112 boys and 83 girls, mean age 8.5 years), 38 with abnormal liver sonograms had a higher incidence of functional abnormalities than those with normal architecture (63% vs lo%, p < 0.0001). The commonest abnormalities associated with abnormal function were signs of HTP (lOO%), of cirrhosis (high attenuation, nodules) (77%), and of steatosis (hyperechogenic livers) (50%). Conclusion: There is a correlation between sonographically abnormal liver architecture (especially signs of HTP and cirrhosis) and 3 tests of liver function (YGT, AST, and ALT). Together, these tests may be appropriate for screening children with CF for liver disease.