The radiologic evaluation of the pediatric acute abdomen

PurposeIn this retrospective study we aimed to evaluate the radiological examinations of the pediatric patients who have initial diagnosis of acute abdomen and were operated in our hospital.Materials and MethodWe retrospectively reviewed the clinical records and imaging findings from the files of 252 children seen on emergency basis with clinical suspicion of acute abdomen and operated between February 2003-December 2009. All patients were evaluated by plain abdominal radiographs (PAX) and ultrasonography (US). Only 10 patients were examined using computed tomography (CT). The findings of the PAX, US and CT of each patient were determined from their detailed archive records according to their clinical diagnosis.ResultsIn our study acute appendicitis was found in 218 of 252 patients. The other patients were diagnosed as intussusception, ovarian torsion, the complications of Meckel?s diverticulum, gastrointestinal obstruction and tuboovarian abscess in decreasing frequency.Roentgenographic findings were detected in 48% of our cases. These findings were air-fluid levels, distension of gas, dilatation of bowel loops, increased soft tissue density in the right lower quadrant and presence of appendicolith. PAXs were valuable in diagnosis of the patients with ileus.Ultrasonography detected a positive finding in 75% of our cases. US findings were pathologic appendix, fluid collections, mesenteric lymph nodes, periappendicular heterogenity, presence of appendicolith, intussusception mass, enlargement of ovaries, decreased or lack of flow in ovaries, dilatation of bowels and mass in the abdomen. It has been showed that US was the most useful for patients with appendicitis and intussusception.CT was performed only in 4% of our cases as an advanced diagnostic method. It was more commonly used in cases with appendicitis and Meckel?s diverticulitis.ConclusionOur study proved that the pediatric patients with acute abdomen have been evaluated radiologically by PAX and US routinely and frequently. CT was performed as an advanced diagnostic method very rarely. The pediatric patients were evaluated by several radiology residents who have different experience levels in radiology in the emergency settingsKey words: plain abdominal radiographs, ultrasonography, computed tomography, pediatric acute abdomen