Open Access, Peer-reviewed
pISSN 2234-8646
eISSN 2234-8840
    Korean J Pediatr Gastroenterol Nutr. 2011 Sep;14(3):245-250. Korean.
    Published online Sep 30, 2011.
    https://doi.org/10.5223/kjpgn.2011.14.3.245
    Copyright © 2011 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
    Review

    Usefulness and Pitfall of Abdominal Ultrasonographic Examination by a Pediatrician in Children

    Jae Hong Park, M.D.
      • Department of Pediatrics, College of Medicine, Pusan National University, Busan, Korea.
    • Corresponding author (Email: jhongpark@pusan.ac.kr )
    Received September 01, 2011; Accepted September 09, 2011.

    Abstract

    Ultrasonographic examination plays an important role in non-invasive and prompt screening examinations in detecting abdominal diseases. In this review, the author's experience of the usefulness and pitfalls of ultrasonographic examinations in children with gastrointestinal symptoms is presented. A total of 1,000 cases of children who underwent ultrasonographic evaluation in the Department of Pediatrics, Pusan National University Hospital were reviewed. The main causes leading to ultrasonographic evaluation were abdominal pain (43.9%), vomiting (17.3%), elevated liver enzymes (11.8%), and jaundice (9.8%). Abnormal ultrasonographic findings accounted for 57.9% of cases. The major abnormal findings were mesenteric lymphadenitis (29.2%), fatty liver (12.1%), hepatitis (6.4%), hepatosplenomegaly (6.2%), and acute appendicitis (4.8%). The major findings in children with abdominal pain were mesenteric lymphadenitis (32.6%), intussusception (2.7%), and acute appendicitis (2.7%). The major findings in children with vomiting were mesenteric lymphadenitis (12.7%), hypertrophic pyloric stenosis (10.4%), acute appendicitis (3.5%). The major ultrasonographic findings in children with urinary tract diseases were hydronephrosis (45.4%), urolithiasis (21.5%) and cystic renal disease (18.1%). Ultrasonography performed by pediatricians is advantageous because pediatricians are able to perform the procedure with clinical information at the right time.

    Keywords
    Abdominal ultrasonography; Children; Pediatrician

    Tables

    Table 1
    Causes Leading to Ultrasonographic Evaluation

    Table 2
    Ultrasonographic Findings in Children with Abdominal Pain

    Table 3
    Ultrasonographic Findings in Children with Vomiting

    Table 4
    Ultrasonographic Findings in Children with Elevated Liver Enzyme

    References

      1. Choi BI. In: Ultrasound diagnosis of upper abdomen. 1st ed. Seoul: Ilchokak; 1997. pp. 1-273.
      1. Auh YH. Abdominal ultrasound examination. J Korean Acad Fam Med 1992;13:469–483.
      1. Han KM, Kim JH, Bae CY, Shin DH. Usefulness of abdominal ultrasonograms in health screen. J Korean Acad Fam Med 1994;15:183–190.
      1. Vasavada P. Ultrasound evaluation of acute abdominal emergencies in infants and children. Radiol Clin N Am 2004;42:445–456.
      1. Kalifa G. In: Pediatric ultrasonography. 2nd ed. New York: Springer-Verlag Co; 1986.
      1. Cheon YJ, Jang HY, Ryu JY, Eo EK, Jung KY. Emergency ultrasonography as a primary screening tool in trauma victims. J Korean Soc Traumatol 2001;14:62–68.
      1. Mason JD. The evaluation of acute abdominal pain in children. Emerg Med Clin North Am 1996;14:629–643.
      1. Moon HS, Woo YN. The diagnostic efficacy of abdominal ultrasonography for evaluation of children with urinary tract infection. Korean J Urol 1996;37:979–985.
      1. Hayden CK Jr. Ultrasonography of the acute pediatric abdomen. Radiol Clin North Am 1996;34:791–806.
      1. Park CH, Lee DH, Kim HL, Park JM, Hwang JB, Kim HS, et al. Clinical observation of mesenteric lymphadenitis in children. Korean J Pediatr 2004;47:31–35.
      1. Sivit CJ, Newman KD, Chandra RS. Visualization of enlarged mesenteric lymph nodes at US examination. Clinical significance. Pediatr Radiol 1993;23:471–475.
      1. Lim HT, Park JK, Choi HJ, Kim JS, Shin HK, Gu CH. Clinical approach of ultrasonography in the diagnosis of intussusception in infant and children. J Korean Pediatr Soc 1994;37:649–654.
      1. Koumanidou C, Vakaki M, Pitsoulakis G, Kakavakis K, Mirilas P. Sonographic detection of lymph nodes in the intussusception of infant and young children: reliability of US in diagnosis. Radiology 1994;191:781–785.
      1. Lee MK, Im CS, An SM, Kim CH, Lee DJ, Kwon JH. Ultrasonography for diagnosis of acute appendicitis in children. J Korean Pediatr Soc 1996;39:497–502.
      1. Smith DE, Kirchmer NA, Stewart DR. Use of the barium enema in the diagnosis of acute appendicitis and its complications. Am J Surg 1979;138:829–834.
      1. Jung TY, Choi DH, Lee CW. A clinical analysis of the appendicitis in children. J Korean Surg Soc 1992;43:767–775.
      1. Seo HS, Chung MH, Kim KT. Ultrasonography for the acute appendicitis. J Korean Radiol Soc 1987;23:998–1007.
      1. Lee JD, Lee JD, Cho JH, Yang JY. Diagnosis of acute appendicitis by ultrasonography. Korean Soc Ultrasound Med 1987;6:158–167.
      1. Abu-Yousef MM, Bleicher JJ, Maber JW, Urdaneta LF, Franker FA, Metcalf AM. High-resolution sonography of acute appendicitis. Am J Radiol 1987;149:53–58.
      1. Rubin SZ, Martin DJ. Ultrasonography in the management of possible appendicitis in childhood. J Pediatr Surg 1990;25:737–740.
      1. Kim JH, Kim WT, Jung BO. Significance between ultrasonographic and operative findings in hypertrophic pyloric stenosis. J Korean Pediatr Soc 2001;44:426–432.
      1. Kang SH, Lee C, Nam GR, Han DK. Ultrasonographic diagnosis of congenital hypertrophic pyloric stenosis. J Korean Pediatr Soc 1989;32:756–764.
      1. Lee SK, Oh JW, Oh YK, Kim CG. Ultrasonographic diagnosis by pyloric volume measurement in congenital hypertrophic pyloric stenosis. J Korean Pediatr Soc 1994;37:1595–1599.
      1. Stunden RJ, LeQuesne GW, Little KE. The improved ultrasound diagnosis of hypertrophic pyloric stenosis. Pediatr Radiol 1986;16:200–205.
      1. Keller H, Waldmann D, Greiner P. Comparison of preoperative sonography with intraoperative findings in congenital hypertrophic pyloric stenosis. J Pediatr Surg 1987;22:950–952.
      1. Cho KH, Hong MH, Yu HD, Lee TH, Cho AK, Park YK, et al. Clinical significance of fatty liver diagnosed by abdominal ultrasonography. J Korean Acad Fam Med 1993;14:734–742.
      1. Kim SH, Kang DH, Lee SH, Yun CH. Causes of fatty liver diagnosed by abdominal ultrasonography. J Korean Acad Fam Med 1995;16:785–794.
      1. Bae SI, Park JH. Analysis of 1,000 cases of abdominal ultrasonography performed by a pediatrician. Korean J Pediatr Gastroenterol Nutr 2007;10:28–35.
    MeSH Terms
    Abdominal Pain
    Appendicitis
    Child
    Fatty Liver
    Hepatitis
    Humans
    Hydronephrosis
    Intussusception
    Jaundice
    Kidney Diseases, Cystic
    Liver
    Mass Screening
    Mesenteric Lymphadenitis
    Pediatrics
    Pyloric Stenosis, Hypertrophic
    Urolithiasis
    Urologic Diseases
    Vomiting
    Metrics
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    Tables
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