Esophageal Heterotopic Pancreas in an Asymptomatic 2-Year-Old With VACTERL Association.

A 2-year-old male with VACTERL association and asthma presented to the emergency room due to asthma exacerbation. Chest radiography revealed lingular pneumonia and thickening of the left paraspinal line of the gastroesophageal junction. Chest computed tomography confirmed a heterogeneous fluid- and gas-filled structure at the left posterior lateral posterolateral aspect of the esophagus, which was suspected to be an esophageal diverticulum on an upper gastrointestinal series. The esophageal diverticulum was excised via left thoracoscopy, and pathological examination revealed pancreatic tissue. Heterotopic pancreas lacks anatomical, vascular, or ductal continuity with the native pancreas. It is usually asymptomatic, but when discovered, it usually occurs later in life. It has been described in the foregut, but is not as common in the esophagus, especially in the pediatric population. This case report highlights the rare occurrence, and importance of considering, esophageal heterotopic pancreas within an esophageal diverticulum in an asymptomatic patient with VACTERL association.

Optimizing Communication With Parents on Benefits and Radiation Risks in Pediatric Imaging.

Effective radiation risk communication is a core competency for radiology care providers and can prevent and resolve potential conflicts while helping achieve effective public health safeguards. The authors present a synopsis of the challenges to holding such dialogue and review published methods for strengthening and maintaining this discourse. Twelve strategies are discussed in this article that can help alleviate concerns about the iatrogenic risk associated with medical imaging using radiation exposure.

Magnetic resonance imaging of the pediatric liver: benign and malignant masses.

Hepatic neoplasms constitute approximately 5% to 6% of all pediatric intra-abdominal masses, most of which are malignant. When compared with traditional multiphase computed tomography protocols that are often used in adults, magnetic resonance (MR) imaging is particularly desirable for evaluating liver lesions in children because of the lack of ionizing radiation and superb soft tissue contrast resolution. The goal of this article is to discuss common benign and malignant pediatric hepatic lesions and their key MR imaging findings. Particular emphasis is placed on the utility of new hepatocyte-specific contrast agents to narrow the differential diagnosis.