Korean J Pediatr Gastroenterol Nutr.  2011 Jun;14(2):141-147. 10.5223/kjpgn.2011.14.2.141.

Usefulness of Ultrasonographic Examination by a Pediatrician in Children with Abdominal Pain

• Park HS
• We JH
• Park JH

• KMID: 2276534
• DOI: http://doi.org/10.5223/kjpgn.2011.14.2.141

Abstract

PURPOSE
Ultrasonography (US) is widely used as a screening test in patients with abdominal pain (AP). We investigated the usefulness of US by a pediatrician in children with AP.
METHODS
We retrospectively analysed the medical records of children with AP who undertook US from December, 2008 to July, 2010.
RESULTS
A total of 628 patients (325 male, 303 female) were enrolled in this study. The mean age of patients was 8.08+/-4.61 years. Duration of AP was acute in 427 and chronic in 201 patients. Localization of AP was diffuse (36.9%), periumbilical (24.4%), epigastric (21.0%), and right lower quadrant (8.1%). On the examination, there were no abnormal findings in 327 patients (52.1%). Abnormal ultrasonographic findings were mesenteric lymphadenitis (27.1%), intestinal mural thickening (10.0%), intussusception (3.0%), appendicitis (2.6%), choledochal cyst (1.6%), and pancreatitis (0.3%). We performed additional imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) in 39 patients who showed obscure findings on the US. In 33 patients (84.6%), the same results were obtained from CT or MRI. Two cases of appendicitis, one case of pancreatitis and one case of Henoch-Shonlein purpura were diagnosed by the CT examination. However, there were two cases of appendicitis diagnosed by US thathad no evidence of appendicitis on the CT. Diagnostic accuracy of initial US in children with abdominal pain was 99.4%.
CONCLUSION
US by a pediatrician as a screening test in children with AP provides a rapid and accurate diagnostic indication and has non-invasive and radiation-free advantages.

Keyword

Abdominal pain; Child; Ultrasonography; Pediatrician

MeSH Terms

Abdominal Pain
Appendicitis
Child
Choledochal Cyst
Humans
Intussusception
Magnetic Resonance Imaging
Male
Mass Screening
Medical Records
Mesenteric Lymphadenitis
Pancreatitis
Purpura
Retrospective Studies

Figure

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  Fig. 1 Localization of abdominal pain. RLQ: right lower quadrant, RUQ: right upper quadrant, LLQ: left lower quadrant, LUQ: left upper quadrant.

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