[Imaging of acute abdomen in childhood and adolescence]

Acute abdomen in pediatric radiology

BACKGROUND

 Imaging is a common part of the workup for acute abdomen in childhood and adolescence. Rapid diagnosis is crucial for adequate therapy, especially in young children.

METHOD

 This review is intended to provide an overview of the typical causes of acute abdomen in children and adolescents and is specifically aimed at radiologists who do not regularly work in pediatric radiology.

RESULTS AND CONCLUSION

 Age-specific peculiarities make a division into three age groups useful: Newborns, infants and toddlers, and schoolchildren. Possible causes of acute abdomen in children range from congenital lesions, particularly in newborns, to entities well known in adult radiology, more commonly in school-aged children. Since younger children have a higher sensitivity to radiation and often a limited ability to cooperate, sonography and conventional X-ray are the primary imaging modalities used. Decisive advantages of sonography, especially in younger children, include its widespread availability, the lack of need for sedation, and the possibility of bedside examination. Supplementary cross-sectional imaging, usually MRI, is reserved for special clinical questions. Close interdisciplinary cooperation between attending clinicians and radiologists is essential for efficient diagnostics in this patient group.

KEY POINTS

  · Age-specific features must be observed. · Sonography and radiography are the most important modalities. · Both congenital and acquired pathologies play a role. · Good interdisciplinary cooperation is essential in this patient group.

CITATION FORMAT

· Lochbühler N, Bölle P, Müller-Abt P. Acute abdomen in pediatric radiology. Fortschr Röntgenstr 2024; 196: 451 - 462.

[Radiological evaluation of acute abdomen in children]

CLINICAL/METHODICAL ISSUE

Acute, non-traumatic abdominal pain is one of the main reasons for medical consultation in pediatric patients. Knowledge of different diseases and their age dependence is essential for correct diagnosis and treatment.

STANDARD RADIOLOGICAL METHODS

Ultrasonography is the imaging method of choice. X‑ray is only used in case of emergency, e. g., suspected perforation.

METHODICAL INNOVATIONS

Contrast-enhanced ultrasonography (CEUS) and elastography complement ultrasonography.

PERFORMANCE

Magnetic resonance imaging is of increasing relevance for differential diagnosis of unclear sonographic results.

PRACTICAL RECOMMENDATIONS

The primary imaging modality in pediatric patients is ultrasonography. Cross-sectional imaging should only be used in cases of unclear sonographic findings.