Diffuse hypoxic-ischemic brain injury in the neonate results in neonatal hypoxic-ischemic encephalopathy (HIE). Because of differences in brain maturity at time of insult, severity of hypotension, and duration of insult, there are four distinct patterns of brain injury. Cranial ultra-sonography and computed tomography reveal periventricular leukomalacia, germinal matrix hemorrhage, and hydrocephalus. Magnetic resonance imaging is the most sensitive modality for evaluating the patterns of brain injury. In preterm neonates, mild hypotension causes periventricular injury; severe hypotension results in infarction of the deep gray matter, brainstem, and cerebellum. In term neonates, mild hypotension causes parasagittal cortical and subcortical injury; severe hypotension causes characteristic injury of the lateral thalami, posterior putamina, hippocampi, corticospinal tracts, and sensorimotor cortex. Prompt recognition of these imaging findings can help exclude other causes of encephalopathy, affect prognosis, and facilitate earlier (although mostly supportive) treatment.

CT is both sensitive and specific for use in diagnosing small-bowel obstruction in children, especially in children older than 2 years.

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Radiograph of the abdomen obtained with the patient prone during a small bowel followthrough study demonstrates marked separation of bowel loops. The bowel wall is diffusely thickened, and mass effect is seen on the barium-filled loops of bowel. The cecum (arrowheads) is displaced medial to adjacent loops of small bowel. Calcifications are not present.

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This article reviews the imaging manifestations of soft-tissue injuries caused by animal bites and insect stings. After completing this article, the reader should have an improved ability to recognize complications of soft-tissue injuries and the role of advanced imaging in select cases.

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