Imaging Acute Abdomen in Children

370 Pages·2018·27.64 MB·English

by  Fred E. Avni

Imaging
Acute Abdomen
in Children
Fred E. Avni · Philippe Petit
Editors
123
Imaging Acute Abdomen in Children
Fred E. Avni • Philippe Petit
Editors
Imaging Acute
Abdomen in Children
Editors
Fred E. Avni Philippe Petit
Department of Pediatric Imaging Department of Prenatal and
Jeanne de Flandre Hospital Pediatric Imaging
Lille Cedex, France Hospital Timone-Enfants
Marseille Cedex 05, France
ISBN 978-3-319-63699-3 ISBN 978-3-319-63700-6 (eBook)
https://doi.org/10.1007/978-3-319-63700-6
Library of Congress Control Number: 2017957596
© Springer International Publishing AG 2018
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Contents
Part I Introduction
1 Paediatric Emergencies: What Is It about?
What Approach? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
François Dubos
2 Surgical Pediatric Imaging: What is It About?
What Approach? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Rony Sfeir
3 Imaging and Emergency: What Modalities?
What Strategies? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Philippe Petit and Fred E. Avni
Part II The Prematurely Born
4 Abdominal Complications in the Premature Infant . . . . . . . . . . 19
Fred E. Avni, Annie Lahoche, Laurent Storme,
and Veronica Donoghue
Part III The Newborn Including The Impact of Antenatal Diagnosis
5 Abdominal Neonatal Emergencies Considering
Prenatal Diagnosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Marie Cassart and Fred E. Avni
6 (Acute) Renal Failure in the Full Term Neonate . . . . . . . . . . . . . 65
Fred E. Avni and Annie Lahoche
7 Acute Presentation of Anomalies of the Digestive Tract
During the Neonatal Period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Elisa Amzallag-Bellenger, Rony Sfeir, Veronica Donoghue,
and Fred E. Avni
8 Obstructive Cholestasis and Acute Hepatobiliary Diseases
in the Neonate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Stéphanie Franchi-Abella and Danièle Pariente
v
vi Contents
Part IV Any Age: Digestive Tract
9 Acute and Subacute Intestinal Obstructions . . . . . . . . . . . . . . . . 105
Eléonore Blondiaux and Winnie Mar
10 Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Alexia Dabadie and Philippe Petit
11 Meckel’s Diverticulum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Brigitte Bourlière and Philippe Petit
12 Inflammatory Bowel Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Nathalie Colavolpe, Stuart Taylor, and Philippe Petit
13 Acute Intestinal Intussusception . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Alexia Dabadie and Philippe Petit
14 Diseases of the Peritoneum, Mesentery, and Omentum . . . . . . . 179
Fred E. Avni and Paul Humphries
15 Acute Hepato-Biliary Diseases in Children . . . . . . . . . . . . . . . . . 197
Stéphanie Franchi-Abella and Danièle Pariente
16 Acute Pancreatitis (AP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
Alexia Dabadie and Philippe Petit
17 Acute Presentations of Splenic Diseases . . . . . . . . . . . . . . . . . . . . 231
Fred E. Avni and Catherine M. Owens
Part V Any Age: The Uro-Genital Tract
18 Urinary Tract Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Pierre-Hugues Vivier and Adnan Hassani
19 Imaging Urolithiasis and Their Complications . . . . . . . . . . . . . . 257
Fred E. Avni, R.-H. Priso, and Robert Novo
20 Acute Urinary Tract Obstruction and Urological
Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267
Fred E. Avni and René-Hilaire Priso
21 Acute Renal Failure in Children . . . . . . . . . . . . . . . . . . . . . . . . . . 277
Fred E. Avni and Annie Lahoche
22 Complicated Urachal Remnants . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Fred E. Avni
23 Complications of Renal Graft . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
Audrey Aschero and Philippe Petit
24 Imaging Emergency Pelvic Diseases in Girls . . . . . . . . . . . . . . . . 301
Pauline Verpillat, Jean-François Chateil, Chantal Durand,
and Fred E. Avni
Contents vii
Part VI Any Age: General Overviews
25 Abdominal Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327
Kathia Chaumoitre and Philippe Petit
26 Foreign Bodies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 345
Alexia Dabadie and Philippe Petit
27 Acute Abdominal Presentations of Neoplasia
and Malignant Hemopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353
Anne M.J.B. Smets, Nathalie Rocourt, Eline E. Deurloo,
and Elisa Amzallag-Bellenger
28 Acute (Abdominal) Presentations of Non-malignant
Hemopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 371
Elisa Amzallag-Bellenger, Anne Smets, and Fred E. Avni
29 Acute Abdominal Presentation of Systemic
Diseases and Vasculitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 375
Catherine Desvignes and Philippe Petit
30 At the Boundaries of the Abdominal Cavity . . . . . . . . . . . . . . . . 381
Fred E. Avni, Nathalie Boutry, and Philippe Petit
Part I
Introduction
1
Paediatric Emergencies: What Is It
about? What Approach?
François Dubos
Contents 1.1 Introduction
1.1 Introduction 3
Abdominal pain or symptoms related to the gas-
1.2 Team Approach 4
trointestinal, urinary or genital tract are common
1.3 Clinical Presentation 4 complaints and frequent reason for admission of
Conclusion 7 children in the emergency department (ED) [1].
Despite the relatively benign nature of the most
References 7
common diseases treated in the paediatric ED,
there are some clinical entities that can have
adverse outcomes.
How high is the index of suspicion among
clinicians for such serious pathologies and how
well aware are they of recent advances in their
diagnosis and treatment? What are the clinical
pitfalls to be avoided? One issue is to detect the
child with a rare and potentially severe condi-
tion among all children with more common
diagnoses in the ED. A second issue is the man-
agement of abdominal diseases in very young
children, who often present with less specific
signs. A third issue is more and more often the
admission of children soon after the onset of
the first symptoms. In this situation, the repeti-
tion of initially normal examinations could be
necessary.
The mechanisms of intra-abdominal diseases
can be of vascular, obstructive or infectious ori-
gin. The causes vary with the age of the child,
although almost all causes can be seen at any age.
F. Dubos For example, intussusception usually occurs in
Paediatric Emergency Unit and Infectious Diseases, children 2 months to 2 years of age. When it is
Lille University and Lille University Hospitals,
described (rarely) in older children, an underly-
59037 CHRU Lille, France
ing disease has to be searched [2].
e-mail: [email protected]
© Springer International Publishing AG 2018 3
F.E. Avni, P. Petit (eds.), Imaging Acute Abdomen in Children,
https://doi.org/10.1007/978-3-319-63700-6_1
4 F. Dubos
The causes also vary according to the duration The demand is usually motivated by a surgical
of the symptoms and the associated signs. hypothesis suggested by the clinician, which may
Recurrent abdominal pain (>3 episodes of pain require urgent surgery (peritonitis, appendicitis,
over a period of at least 3 months) suggests a intestinal obstruction, etc.). It can also be moti-
functional cause (in 80% of cases). On the other vated by a medical hypothesis justifying the
hand, a surgical cause must be suggested first in implementation of an urgent or rapid treatment
case of acute pain. The radiologist must therefore (foreign body, rheumatoid vasculitis, pancreati-
be vigilant in seeking first the urgent causes, usu- tis, abdominal tumour, etc.).
ally surgical. He/She must also be able to search
for rare or unusual causes when the clinical pre-
sentation is atypical. 1.3 Clinical Presentation
The causes that can be raised will vary according
1.2 Team Approach to the main anamnestic signs reported by the par-
ents or the child. These main symptoms are listed
In this situation of abdominal emergency with in Table 1.1 with the diseases most frequently
uncertainty on the definitive diagnosis, the impor- related and the causes that should not be missed.
tance of a team approach is crucial: nurses, emer- Abdominal surgical causes should be sought
gency clinicians, radiologists, anaesthesiologists, as first line. Regurgitation with pain is usually
surgeons, etc. The role of the radiologists within of medical benign origin but can be related to
the team, particularly for acutely ill appearing surgical causes such as intussusception, volvu-
children, is a key factor for the success of a good lus and incarcerated hernia. In case of vomit-
management. Several generic skills are expected ing, gastrointestinal surgery should be given
of all health professionals involved with the care priority, particularly in case of bilious vomiting
of sick children [3, 4]. These are: in infants, which is an alarming symptom that
necessitates exclusion of midgut volvulus. In
1. To recognise the critically sick or injured case of abdominal mass, think of acute urinary
child; retention, abdominal tumour (nephroblastoma,
2. To initiate appropriate initial treatment; neuroblastoma, lymphoma, hepatic tumour
3. To work as part of a team for a rapid and (hepatoblastoma, cyst, abscess, etc.)), tumour of
appropriate management; the female genital tract (cyst/ovarian tumour),
4. To know how to challenge oneself and main- splenomegaly (erythroblastopenia, kala azar,
tain/enhance skills; etc.). Haematemesis is rarely a sign that justifies
5. To be aware of issues/pitfalls around some emergency imaging. When additional investi-
uncommon presentations; gation is necessary in this case, it is usually an
6. To verify and continuously ensure children oesogastroduodenal endoscopy. Children with
safety; abdominal trauma are usually well identified.
7. To communicate effectively with children and A careful screening of those children is needed
parents/carers. to detect trauma of the gut or solid organs. The
growing expansion of fast ultrasound at the bed-
When the physician asks for the realisation of side should be a factor to improve this interac-
abdominal imaging in the ED, the non-urgent tion between physicians.
medical causes have usually been previously Table 1.2 provides a classification of the
eliminated by the history of the disease and by causes responsible for abdominal diseases by age
the clinical examination. group.