Color Doppler US of children with acute lower abdominal pain.

Abstract

The authors review the color Doppler ultrasonographic (US) features of appendicitis and other diseases that can manifest with acute lower abdominal pain. Causes of acute abdominal pain, other than appendicitis, include gynecologic abnormalities (ovarian cyst, ovarian torsion, pelvic inflammatory disease), gastrointestinal abnormalities (infectious enteritis, Crohn disease, mesenteric lymphadenitis, intussusception), and urinary tract diseases. On color Doppler images, inflammatory and infectious processes usually show locally increased blood flow, whereas cysts and twisted masses have absent blood flow. Enlarged lymph nodes also are avascular. Color Doppler US is a useful adjunct to gray-scale US in evaluating acute lower abdominal pain in children and can aid in defining and clarifying gray-scale abnormalities.

Ultrasound in newborns and children suffering from non-traumatic acute abdominal pain: imaging with clinical and surgical correlation

“…7) [5,9]. Color Doppler examination can show an increase of vascularity of the appendiceal wall in the first stage and loss of vascularity in the later stage [3]. Failure to identify the appendix by US or identification of a normal appendix less than 6 mm in diameter makes the diagnosis of appendicitis very unlikely.…”

“…Differential diagnoses include: Crohn's disease, ovarian pathologies, mesenteric adenitis, nephrolithiasis and Meckel's diverticulitis (Fig. 8) [1,3,6,7,10]. Mesenteric adenitis…”

“…Commonly this condition is mistaken for appendicitis, as the signs and symptoms are very similar. It is classified as primary or idiopathic and secondary, depending on an identifiable inflammatory process [3,7]. US ( Fig.…”

“…The goal of emergency management is to identify and treat any lifethreatening medical or surgical condition and relief from pain. US in conjunction with color Doppler study is helpful for assessing organ perfusion and diagnosing inflammation [3]. US is extremely beneficial in the evaluation of acute pediatric abdominal diseases, allowing, in most cases, the visualization of the direct cause, without ionic radiation use, and helping in delineating the management plan of the patients [2,4].…”

The Role of Ultrasound in Intestinal Inflammatory Processes in Children and Adolescents

“…The first studies in children were performed by Quillin and Siege [29,30] that noted that in the color Doppler can differentiate extrinsic causes of intestinal disease, such as peritonitis, to primary intestinal processes and identify different locations compromised. Several authors have suggested US as the first study to be conducted in the diagnostic investigation process of suspected inflammatory bowel disease [13,[31][32][33].…”