Minimal Pelvic Fluid in Asymptomatic Children

Rathaus, Valeria; Grunebaum, Michael F.; Konen, Osnat; Odsatchy, Alexandra; Zissin, Rivka; Shapiro, Myra; Werner, Miriam

doi:10.7863/jum.2003.22.1.13

Cited by 11 publications

(19 citation statements)

References 7 publications

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“…Rathaus et al evaluated intra-abdominal FF in 266 patients with acute and/or chronic abdominal pain versus 396 asymptomatic pediatric patients and reported a significantly higher rate of FF in children with abdominal pain (28.6%) as compared to asymptomatic children (7%). Gender did not affect the presence of FF in the present study, similar to results by Rathaus et al [16]. Patients that had FF in the Douglas and pelvic areas were also significantly younger while 85.4% of postmenopausal women did not have FF.…”

Section: Discussionsupporting

confidence: 91%

Significance of Intra-abdominal Free Fluid Detected in Ultrasonography in the Clinical Assessment and Outcomes of Adult Patients Presenting to the Emergency Department Due to Abdominal Pain

Erkek¹,

Aydın²,

Çiftçi³

et al. 2019

Cureus

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ObjectiveThe aim of the study was to evaluate the diagnostic process and clinical course in adult patients who presented to the emergency department (ED) with acute abdominal pain (AAP) and were found to have intra-abdominal free fluid (FF) on ultrasonography (USG).MethodsThis prospective observational study was conducted in a training and research hospital adult emergency department between March 15, 2013, and April 15, 2013. The study included 252 patients aged above 18 years, who were admitted to the emergency room complaining of non-traumatic acute abdominal pain and provided consent for the study.ResultsThe most common diagnoses were acute, nonspecific abdominal pain (37.3%), acute appendicitis (19%), and urinary tract pathology (15.9%). Intra-abdominal free fluid was detected with ultrasonography in 42.5% of patients. Patients with intra-abdominal free fluid were younger than the other patients. The emergency department length of stay was longer in patients with intra-abdominal free fluid (p=0.011). Of the 252 patients enrolled in the study, 32.9% were admitted to the hospital, 21.4% of whom underwent surgery and 11.5% received medical therapy. Most of the patients (64.5%) who were discharged home had no intra-abdominal free fluid in the ultrasonography (p<0.001).ConclusionThe presence of intra-abdominal free fluid alone did not guide the clinical decision regarding the diagnostic evaluation of adult patients that presented to the emergency department complaining of non-traumatic acute abdominal pain.

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Section: Discussionsupporting

confidence: 91%

Significance of Intra-abdominal Free Fluid Detected in Ultrasonography in the Clinical Assessment and Outcomes of Adult Patients Presenting to the Emergency Department Due to Abdominal Pain

Erkek¹,

Aydın²,

Çiftçi³

et al. 2019

Cureus

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“…The presence of free intraperitoneal fluid may be a cardinal sign of an acute inflammatory process in a patient with abdominal pain in a nontraumatic setting. Small amounts of free fluid have been found on diagnostic imaging and are considered physiologic in asymptomatic children 1 , 2 . Although a finding of free intraperitoneal fluid among children with blunt abdominal trauma may signal an associated solid or hollow viscous injury, recent studies have suggested that isolated free intraperitoneal fluid detected on diagnostic imaging in pediatric trauma patients, with no associated findings of solid‐organ injury, a normal mental status, and lack of abdominal tenderness, may be managed conservatively without surgery 3 – 5 .…”

mentioning

confidence: 99%

Clinical Outcomes of Pediatric Patients With Acute Abdominal Pain and Incidental Findings of Free Intraperitoneal Fluid on Diagnostic Imaging

Matz

Connell²,

Sinha³

et al. 2013

J of Ultrasound Medicine

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“…In previous studies, prevalence of fluid in asymptomatic children with a few comorbidities during their visits was approximately 12% [1–3]. In this study, the prevalence of fluid within both female (91%) and male (67%) groups was much higher.…”

Section: Discussionmentioning

confidence: 43%

“…However, detection of minimal PFF in healthy children is not uncommon, possibly due to increased peritoneal permeability [1, 2]. Previous studies using ultrasonography have indicated a higher prevalence (12 %) of PFF in asymptomatic children aged 9 to 15 years compared to other age groups, with the maximum volume ranging from 1 – 6.9 mL [1–3]. While ultrasonography remains the most readily available modality for evaluation of PFF, the sensitivity for detection of free pelvic fluid is greatly improved with MRI.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of incidental pelvic fluid in relation to physiological changes in healthy pubescent children using pelvic magnetic resonance imaging

et al. 2019

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Background: Peritoneal free fluid (PFF) can indicate an underlying disease process; however, detection of minimal PFF in healthy children is not uncommon. Objective: To assess the significance of incidental PFF within healthy children by MRI and its relation to physiological changes during puberty. Methods: This prospective study was performed on 32 healthy volunteers (20 males) between the ages of 8 to 13 years, with consecutive follow-ups every 8–10 months for an average of 3 years. BMIz score, pubertal status, C-reactive protein and sex hormone concentrations assessed prior to MRI studies. A total of 120 pelvic MRI studies (61 males) were reviewed, and the quantity of PFF was measured. Linear mixed model accounting for within-patient correlations was used for statistical analysis. Results: The mean ± standard deviation volume of PFF was 4.7 ± 5.65 mL in females and 1.9 ± 3.11 mL in males with a maximum volume of 25 mL and 17 mL, respectively. The prevalence of PFF was significantly higher in females (91%) compared to males (67%) (P = 0.0035). In 15% of the females and 3% of the males the fluid was greater than 10 mL. The mean volume of PFF in 4th stage was higher and significantly different with the first stage of puberty (P = 0.01). Conclusion: Among healthy pubescent children, the prevalence of PFF is significantly higher in females. The volume of PFF may reach volumes greater than 10 mL during normal puberty, especially in 4th stage, and can be assumed normal in the absence of active disease.

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Minimal Pelvic Fluid in Asymptomatic Children

Abstract: Our data suggest that the presence of minimal pelvic fluid in children of all ages and both sexes is a physiologic finding and should be evaluated in the appropriate clinical context.

Cited by 11 publications

References 7 publications

Significance of Intra-abdominal Free Fluid Detected in Ultrasonography in the Clinical Assessment and Outcomes of Adult Patients Presenting to the Emergency Department Due to Abdominal Pain

Significance of Intra-abdominal Free Fluid Detected in Ultrasonography in the Clinical Assessment and Outcomes of Adult Patients Presenting to the Emergency Department Due to Abdominal Pain

Clinical Outcomes of Pediatric Patients With Acute Abdominal Pain and Incidental Findings of Free Intraperitoneal Fluid on Diagnostic Imaging

Evaluation of incidental pelvic fluid in relation to physiological changes in healthy pubescent children using pelvic magnetic resonance imaging

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