Emergency ultrasonography of the gastrointestinal tract of children

Hwang, Jae-Yeon

doi:10.14366/usg.16052

Cited by 13 publications

(8 citation statements)

References 34 publications

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“…Gluckman et al found that the recurrence of intussusception could be reduced by adding dexamethasone to the enema 32 . Mesenteric lymphadenitis is clinical disease that is diagnosed after excluding other causes of abdominal pain 15 . Although high‐frequency ultrasound is the first choice for diagnosis of it, the diagnostic criteria are controversial 15,33 .…”

Section: Discussionmentioning

confidence: 99%

“…32 Mesenteric lymphadenitis is clinical disease that is diagnosed after excluding other causes of abdominal pain. 15 Although high-frequency ultrasound is the first choice for diagnosis of it, the diagnostic criteria are controversial. 15,33 We choose this standard of three or more lymph nodes >5 mm in the short axis for two reasons.…”

Section: Discussionmentioning

confidence: 99%

“…Three or more mesenteric lymph nodes were detected within or outside of the sleeve, and the short axis was greater than 0.5 cm, which was diagnosed as enlarged mesenteric lymph nodes (Figure 1C). 15 The sonographers have more than 1 year of working experience in pediatric examination. The results of ultrasound evaluation were recorded including size, location, morphology, structure, and number of masses and lymph nodes, abdominal effusion, and intestinal obstruction.…”

Section: Methodsmentioning

confidence: 99%

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Ultrasound Findings to Predict Risk of Recurrence in Pediatric Intussusception After Air Enema Reduction

Zhang

Shao

Wei

et al. 2021

J of Ultrasound Medicine

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Objectives Intussusception is one of the most common abdominal emergencies in early children. Intussusception recurs in 8–20% of children after successful nonoperative reduction. The aim of this study was to explore the ultrasound findings to predict risk of recurrence in pediatric intussusception after air enema reduction. Methods A total of 336 intussusception children were followed up for 1 year after received successful air enema reduction. They were divided into the recurrent group and the non‐recurrent group. The differences of clinical characteristics, ultrasonic features, and laboratory tests were analyzed by univariate analyses and the Cox proportional hazard model. Results Sixty‐five children with recurrent intussusception were identified. There were statistically significances in the diameter of the mass, in the presence or absence of enlarged lymph nodes out of the sleeve, and in the sleeve between recurrent and non‐recurrent groups (P < .05). Other ultrasonic features, clinical characteristics, and blood parameters had no differences (P > .05). Multivariate Cox proportional hazard model showed that the diameter of the mass and abdominal lymph nodes may be the risk factors of intussusception recurrence (HR = 1.395, 95% CI: 1.045~1.863 and HR = 2.078, 95% CI: 1.118~3.865, P < .05). The cut‐off value of mass diameter was 2.55 cm, above which recurrence is more likely. Conclusions Intussusception recurrence was prone with greater mass diameter (>2.55 cm) and enlarged abdominal lymph nodes. Although these ultrasound findings for recurrence do not necessarily reduce the rate of recurrence, it can predict the recurrent possibility, and help the emergency physicians to be more vigilant in these children and better counsel parents upon discharge.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Ultrasound Findings to Predict Risk of Recurrence in Pediatric Intussusception After Air Enema Reduction

Zhang

Shao

Wei

et al. 2021

J of Ultrasound Medicine

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“…Although US is beneficial for detecting superficially located foreign bodies and their complications [ 8 ], it may not be useful for diagnosing small foreign bodies confined to the deep portion of the abdomen with complex bowel loops, abundant bowel gas, and significant feculent materials, even with experienced operators. However, the proper selection of transducers and the use of gradual compression techniques may improve operator performance [ 9 ]. High-frequency linear transducers are especially helpful for identifying exact localization in the GI tract.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Nonmigrating Metallic Foreign Bodies in the Abdomen Using Ultrasound: An Alternative Approach Using a Traditional Method

Pak

Lee

Hwang

2022

Pediatr Gastroenterol Hepatol Nutr

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Ingestion of foreign bodies (FBs) is a common phenomenon among young children. Plain radiography is the first step diagnostic modality to detect the radio-opaque FBs. And computed tomography has been recommended by several guidelines as useful modalities for diagnosing ingested FBs. However, there is a risk of radiation exposure, making it burdensome to use in asymptomatic patients. Ultrasound (US) is not a commonly used technique for diagnosing ingested foreign bodies. However, US can provide real-time imaging with good resolutions without radiation exposure in pediatric patients. Herein, we report two pediatric cases of metallic foreign body ingestion that were successfully diagnosed using US for localizing foreign bodies. This study indicates that US may be used as an alternative method for detecting the localization of metallic foreign bodies in the gastrointestinal tract without exposure of radiation, particularly in pediatric patients.

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“…Ultrasound typhlitis findings in adults are not commonly described, because adult bowel evaluation in the emergency settings is still not widely performed. The careful evaluation of bowel wall thickening combined with ancillary findings such as fluid collection, increased echogenicity of bowel layer or the mesenteric fat tissue, enlarged lymph nodes, hyperemic bowel changes, and abnormal bowel peristalsis can increase the diagnostic capability of US [11][12][13][14]. At US, typhlitis presented bowel wall thickening that produced a target or halo sign, with hyperechogenic submucosa suggestive of colitis.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound diagnosis of typhlitis

Tamburrini¹,

Setola²,

Belfiore³

et al. 2018

J Ultrasound

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Purpose Typhlitis, also known as neutropenic colitis, is a rare inflammatory condition and a potentially life-threatening disease process that typically involves the cecum. Delay in diagnosis may lead to a fatal prognosis with a death rate of 21-48%. Ultrasound evaluation of right lower quadrant may lead to an accurate and rapid diagnosis. Methods We describe the case of a 59-year-old female with advanced Churg-Strauss syndrome treated with cyclophosphamide, with acute right lower quadrant pain. Results Ultrasound was the first diagnostic step in the diagnosis of typhlitis. Sonographic findings were comparable to CT imaging. Conclusions Bowel bedside ultrasound evaluation in emergency settings may lead to a prompt and definitive diagnosis. Although CT is considered the gold standard in the diagnosis and staging of neutropenic colitis, ultrasound was able to identify the pathology accurately. Ultrasound findings of typhlitis are highly characteristic, showing circumferential wall thickening with predominant submucosa. Keywords Bedside ultrasound • Typhlitis • Bedside • Acute colitis • Emergency ultrasound SOMMARIO La tiflite, nota anche come colite neutropenica, è una rara forma di colite infiammatoria potenzialmente mortale (21-48%) che coinvolge il cieco, correlata ad alta mortalità se diagnosticata tardivamente. La tipica sintomatologia e localizzazione a livello cecale, rendono la valutazione ecografica e la conoscenza della patologia fondamentale, consentendo una diagnosi differenziale rapida ed efficace. Descriviamo il caso di una donna di 59 anni affetta da sindrome di Churg Strauss, in trattamento con ciclofosfamide che presentava dolore addominale localizzato al quadrante inferiore destro. L'ecografia della fossa iliaca destra ha dimostrato un quadro caratteristico e sovrapponibile ai reperti TC, con presenza di ispessimento e stratificazione parietale del ceco e dell'ultima ansa con prevalenza della sottomucosa. L'esame ecografico dell'intestino in emergenza è in grado di diagnosticare rapidamente ed efficacemente molte patologie intestinali acute, consentendo di differenziare tra patologie chirurgiche non chirurgiche. Nel caso della colite neutropenica, anche se La TC è ancora considerata il gold standard diagnostico, l'esame ecografico può identificare correttamente il quadro patologico ed essere una valido strumento diagnostico per il monitoraggio. I segni ecografici di tifilite sono estremamente caratteristici mostrando un incremento di spessore di parete circonferenziale con prevalenza ed iperecogenicità della sottomucosa.

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Emergency ultrasonography of the gastrointestinal tract of children

Cited by 13 publications

References 34 publications

Ultrasound Findings to Predict Risk of Recurrence in Pediatric Intussusception After Air Enema Reduction

Ultrasound Findings to Predict Risk of Recurrence in Pediatric Intussusception After Air Enema Reduction

Diagnosis of Nonmigrating Metallic Foreign Bodies in the Abdomen Using Ultrasound: An Alternative Approach Using a Traditional Method

Ultrasound diagnosis of typhlitis

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