RESUMO
Peritonsillar infections are one of the most common deep neck space infections, particularly in adolescents. Inaccurate diagnosis can lead to delay in management and potentially life-threatening complications. Contrast-enhanced computed tomography (CT) scan of the neck traditionally has been used to diagnose suspected peritonsillar abscess. With growing concern over radiation exposure, there has been increasing utilization of ultrasound (US) using intraoral and transcutaneous approaches. We chose the transcutaneous US technique due to its ease of performance in children. The purpose of this article is twofold: a) to describe our technique of performing transcutaneous US of the tonsil showing sonographic appearance of normal tonsil, highlighting pertinent anatomy and unique considerations for this modality in children, and b) to illustrate the sonographic findings in the spectrum of pediatric peritonsillar infections, which includes uncomplicated tonsillitis, peritonsillar cellulitis, small intratonsillar abscess and frank peritonsillar abscess. Parapharyngeal abscess can sometimes be detected.
Assuntos
Abscesso Peritonsilar/diagnóstico por imagem , Ultrassonografia/métodos , Criança , Meios de Contraste , Diagnóstico Diferencial , HumanosAssuntos
Hepatopatias/diagnóstico , Adenoma/diagnóstico , Adolescente , Infecções Bacterianas/diagnóstico , Carcinoma Hepatocelular/diagnóstico , Criança , Pré-Escolar , Cisto do Colédoco , Cistos/congênito , Cistos/diagnóstico , Diagnóstico Diferencial , Fígado Gorduroso/diagnóstico , Feminino , Hiperplasia Nodular Focal do Fígado/diagnóstico , Hamartoma/diagnóstico , Hemangioma/congênito , Hemangioma/diagnóstico , Hepatoblastoma/diagnóstico , Humanos , Lactente , Infarto/diagnóstico , Abscesso Hepático Amebiano/diagnóstico , Hepatopatias/congênito , Hepatopatias Parasitárias/diagnóstico , Neoplasias Hepáticas/congênito , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/secundário , Imageamento por Ressonância Magnética , Masculino , Micoses/diagnóstico , Tomografia Computadorizada por Raios X , Ultrassonografia , Adulto JovemRESUMO
We present the case of a 13-year-old girl with a recurrent urinary tract infection, malodorous vaginal discharge, and urinary incontinence caused by a retained vaginal foreign body. The foreign body, an aerosol cap retained for over 2 years, resulted in the formation of a ureterovaginal fistula, an extremely rare complication. The critical value of ultrasound and magnetic resonance urography in delineating the foreign body, the fistulous tract, and the intraperitoneal urine leak is described. Through this unique diagnostic dilemma, we wish to highlight that the evaluation of persistent unusual urinary symptoms and vaginal discharge in a young girl must include a thorough pelvic examination and focused imaging to look for retained vaginal foreign bodies.