Sonographic appearances of common gut pathology in paediatric patients: comparison with plain abdominal radiography

Even with the advent of more specialised imaging modalities such as fluoroscopic contrast examinations, CT and MRI, the plain abdominal radiograph remains the initial imaging modality in investigating the signs and symptoms of suspected gut pathology. However, ultrasound is playing an increasing part in the detection of gut pathology in paediatric patients. At our hospital, when plain abdominal radiography does not provide a diagnosis, ultrasound is commonly requested to rule out conditions that require urgent attention, such as intussusception, appendicitis and midgut malrotation and volvulus. After these conditions have been excluded however, the ultrasound examination can frequently lead to the diagnosis of several other conditions, including gastroenteritis, Crohn's disease, mesenteric lymphadenopathy and less commonly, duplication cysts, bezoas, and haemolytic uraemic syndrome. Although plain radiography of the abdomen may be suggestive of gut pathology, the additional information provided by sonography often provides a specific diagnosis, leading to better patient care. This paper is a presentation of ten case studies demonstrating the use of ultrasound to augment plain X-ray findings, in order to obtain a final diagnosis. Copyright (2004) Australian Institute of Radiography