Common and uncommon applications of bowel ultrasound with pathologic correlation in children.

OBJECTIVE: The purpose of this article is to describe the indications and techniques for bowel ultrasound for inflammatory bowel disease and other common and uncommon entities and describe and illustrate their imaging appearances, including endoscopic or surgical correlation. CONCLUSION: Ultrasound is a useful tool for the evaluation of inflammatory bowel disease and many other bowel diseases. Radiologists must become familiar with the full potential of ultrasound in the evaluation of the bowel in children because the need for alternative radiation-free imaging techniques continues to grow.

Is ultrasound useful in detection and follow-up of gastric foreign bodies in children?

OBJECTIVE: The objective was to show potential value of ultrasound in detection and follow-up of gastric foreign bodies. MATERIAL AND METHODS: Medical records of 18 children with gastric foreign bodies were evaluated retrospectively. RESULTS: The following gastric foreign bodies were identified: eight coins, five button batteries, domino, lollipop stick, hairclip, screw nut, and small plastic cylinders. All were confirmed by ultrasound. The batteries, domino, and two coins were removed endoscopically, the screw nut was removed surgically, while the rest were recovered in the stool. CONCLUSIONS: Ultrasound examination of water-filled stomach can be useful in diagnostic workup of gastric foreign bodies in children, especially radiolucent ones.

Aberrant right common carotid and subclavian arteries causing tracheoesophageal compression combined with persistent left superior vena cava--case report.

Vascular rings are a rare group of congenital thoracic vascular anomalies which are characterized by abnormal vascular structures that completely or incompletely encircle the trachea, esophagus, or both. We report the case of a vascular ring formed around the trachea and esophagus by aberrant right subclavian artery and aberrant right common carotid artery, associated with persistent left superior vena cava, complete absence of azygos vein, and with multiple nonvascular abnormalities. Recurrent pulmonary infections were the only clinical manifestation of this complex vascular anomaly. Our report represents a so-far-undescribed anatomic variation of the vascular ring that clinicians should be aware of.

[Ultrasound-guided water enema for reduction of childhood intussusception].

INTRODUCTION: Intussusception is a common abdominal emergency in infants and children. Ultrasonography and barium enema are very useful in diagnosis and treatment of this condition. The aim of the study was to assess the accuracy of ultrasound-guided saline enema for intussusception and to determine if some factors may improve the outcome of this technique. MATERIAL AND METHODS: Intussusception was diagnosed in 63 patients at the Clinic of Pediatric Surgery in Novi Sad. The study period was divided into two 2-year phases: phase I, from 2001 through 2002, and phase II, from 2003 through 2004. During phase I, besides barium enema and fluoroscopy, we started using ultrasonography and ultrasound-guided hydrostatic saline enema in the diagnosis and reduction of intussusception. In phase II, this method of reduction was routinely used in all cases. Our technique of ultrasonic reduction was similar to the conventional hydrostatic barium reduction, except the reservoir was higher than that of barium, analgosedation of patients was performed and in case of difficult and prolonged reduction, gentle manual pressure to the abdomen at right lower quadrant was used. RESULTS: In phase I the diagnostic accuracy of ultrasonography in detecting intussusception was 53.8%, and 100% in phase II. The success rate of ultrasound-guided saline enema was 55.5% in phase I, and 83.8% in phase II. Only 6 patients (16.2%) underwent operative manual reduction of intussusception in phase II. There were no cases with boewl gangrene or perforations in both groups. CONCLUSIONS: Ultrasonography is a useful screening tool in the diagnosis of intussusception. Tme main advantage of hydrostatic reduction with ultrasound guidance is avoidance of ionizing radiation. The success rate of this method of reduction may be increased with an integrated team approach to the management and with modifications of the technique.

[Ultrasonography in the diagnosis of hypertrophic pyloric stenosis and intussusception--emergency conditions in pediatric gastroenterology].

UNLABELLED: Hypertrophic pyloric stenosis (HPS) is the most common abdominal surgical condition in newborns and infants, while intussusception is the most frequent problem in children between the ages of 6 months and 2 years. The aim of this study was to show the advantages of ultrasonography in diagnosis of hypertrophic pyloric stenosis and intussusception and also to point out the efficiency of ultrasound guided hydrostatic reduction of childhood intussusception, as a nonoperative therapeutic option. MATERIAL AND METHODS: This study had a prospective design and included 208 patients in a 2-year period (2004-2005). Both US examinations were done using a linear 7.5 MHz probe, and the main ultrasound criteria for HPS were increased pyloric muscle thickness of 3 mm and over, as well as pyloric length over 15 mm, typical ultrasonic findings of intussusception included a target sign or a pseudokidney sign. Sonographically guided hydrostatic reduction of intussusceptions was also performed. RESULTS: HPS was predominant in male infants, and the mean age was 40 days. The mean pyloric muscle thickness was 4.95 mm in infants with HPS, and the average length of the antroplyloric canal was 19.26 mm. In patients with intussusception, male predominance was also observed and the mean age was 1 year and 79 days. The intussusceptum was most often located in the cecoascending (53.6%) and transverse colon (21.4%). US-guided hydrostatic reduction of intussusception was successful in 82.14% of all cases. DISCUSSION: Our findings are in absolute agreement with literature data regarding the average age of patients, both with HPS and intussusception, thickness of the muscular layer, length of the antropyloric canal, and extremely successfid US-guided hydrostatic reduction of intussusceptions. CONCLUSION: Ultrasonography has proved to be a remarkably precise diagnostic modality in diagnosing HPS and intussusception, but also makes nonoperative treatment of intussusceptions possible in extremely high percentage.