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PAEDIATRIC ABDOMEN ULTRASOUND
Category: Diagnostic Radiology
Abstract : Ultrasound of the paediatric abdomen requires different techniques and skills
from those used in the adult. Although there are a few situations in which
knowledge of adult pathology can be applied to the paediatric patient, the child
cannot simply be considered a mini-version of an adult. The presenting symptoms
and pathological processes in the child are generally quite different from tho
Ultrasound of the paediatric abdomen requires different techniques and skills
from those used in the adult. Although there are a few situations in which
knowledge of adult pathology can be applied to the paediatric patient, the child
cannot simply be considered a mini-version of an adult.
The presenting symptoms
and pathological processes in the child are generally quite different from those
in adults and the operator must be fully aware of the special considerations of
the paediatric patient in terms of both diagnosis and technique. This chapter
addresses only the most common paediatric situations likely to be encountered in
a general department, and further specialist paediatric reading is
recommended.
ultrasound techniques
The operator can minimize any
distress to the child, and make the examination considerably easier and quicker,
in numerous ways.
● The ultrasound environment should be as friendly as
possible, with appropriate decorations and toys, and should always be kept warm
(nothing is more likely to make your patient uncooperative than cold gel).
Minimize the time the child spends in the scanning room by having everything
ready first. Small children may benefit from seeing a video of a scan beforehand
and being reassured that it will not hurt.
● Most children find it
reassuring to be accompanied by their carer during the examination.
●
Separate facilities, such as a dedicated children’s waiting area, are preferable
and more reassuring for the child.
● The equipment should incorporate a
range of high-frequency (5–15 MHz) transducers with small as well as
conventional footprints. A small curvilinear transducer is useful for most
abdominal work and a high-frequency linear probe is essential for bowel
sonography and assessment of the acute abdomen. Transducers with a dynamic
frequency facility are an excellent choice, as it is easy to switch to the
highest possible frequency without having to change the transducer. The use of
more than one transducer, that is, both curvilinear and linear, may be
necessary, particularly in the assessment of the acute abdomen.
● A cine
facility on the ultrasound machine is invaluable, and cuts down scanning time.
Colour Doppler is essential in the assessment of hepatobiliary problems and the
examination of the acute abdomen.
● Generally speaking it is necessary to
employ a fast frame rate. (The smaller field of view needed for children allows
the line density to remain high, maintaining adequate resolution.)
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