1
|
Verma A, Suryawanshi P, Chetan C, Oka G, Singh Y, Kallimath A, Singh P, Garegrat R. A detailed echocardiographic evaluation of ventricular functions in stable full term small for gestational age babies. J Ultrasound 2023; 26:117-127. [PMID: 35616853 PMCID: PMC10063694 DOI: 10.1007/s40477-022-00691-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/23/2022] [Indexed: 10/18/2022] Open
Abstract
PURPOSE SGA infants with fetal growth restriction have reduced ability to adapt themselves to the postnatal life because of certain epigenetic changes in cardiac function. The aim of the present study is to assess and compare the cardiac functions of fetal growth restricted SGA newborns to the term stable AGA newborns, and evaluate any differences in the cardiac functions during the postnatal transitional circulation. METHOD This observational study was conducted at a multispecialty tertiary care hospital in Western India from June to November 2021. The newborns were evaluated using bedside echocardiography at 24-48 h and repeat screening after 48 h. The echocardiographic assessment of the systolic function was done using EF, FS, FAC and TAPSE; diastolic function using E/A wave ratio and global functioning using LV MPI. RESULT Twnety-four babies were included in cases and 30 in the control arm of the study. Maternal and newborn characteristics were comparable between the two groups. FS, EF for left ventricle and TAPSE, FAC for right ventricular systolic function were significantly lower in SGA group (p = 0.02, 0.02, 0.00 and 0.01; respectively). The current study revealed a lower tricuspid E/A ratio and higher mitral E/A ratio with a significant difference beyond 48 h in the first week of life (p value 0.00). Left ventricular MPI was significantly higher in SGA infants compared to AGA infants during two subsequent readings in immediate newborn period with p values 0.01 and 0.02 respectively. The subgroup analysis revealed that fetal growth-restricted neonates with absent end-diastolic flow had a greater impact on ventricular functions. CONCLUSION Present study showed a significant systolic and diastolic dysfunction during initial newborn period in growth restricted SGA infants.
Collapse
Affiliation(s)
- Arjun Verma
- Department of Neonatology, Bharati Vidyapeeth University Medical College, Hospital and Research Center, Pune, Maharashtra, India
| | - Pradeep Suryawanshi
- Department of Neonatology, Bharati Vidyapeeth University Medical College, Hospital and Research Center, Pune, Maharashtra, India.
| | - Chinmay Chetan
- Department of Neonatology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Gauri Oka
- Department of Research, Bharati Vidyapeeth University Medical College, Hospital and Research Center, Pune, Maharashtra, India
| | - Yogen Singh
- Department of Pediatrics, Division of Neonatology, Loma Linda University School of Medicine, Loma Linda, CA, 92354, USA
| | - Aditya Kallimath
- Department of Neonatology, Bharati Vidyapeeth University Medical College, Hospital and Research Center, Pune, Maharashtra, India
| | - Pari Singh
- Department of Neonatology, Bharati Vidyapeeth University Medical College, Hospital and Research Center, Pune, Maharashtra, India
| | - Reema Garegrat
- Department of Neonatology, Bharati Vidyapeeth University Medical College, Hospital and Research Center, Pune, Maharashtra, India
| |
Collapse
|
2
|
Hwang M, Tierradentro-Garcia LO. A concise guide to transtemporal contrast-enhanced ultrasound in children. J Ultrasound 2023; 26:229-237. [PMID: 35567704 PMCID: PMC10063699 DOI: 10.1007/s40477-022-00690-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/22/2022] [Indexed: 12/27/2022] Open
Abstract
Brain contrast-enhanced ultrasound offers insights into the brain beyond the anatomic information offered by conventional grayscale ultrasound. In infants, the open fontanelles serve as acoustic windows. In children, whose fontanelles are closed, the temporal bone serves as the ideal acoustic window due to its relatively smaller thickness than the other skull bones. Diagnosis of common neurologic diseases such as stroke, hemorrhage, and hydrocephalus has been performed using the technique. Transtemporal ultrasound and contrast-enhanced ultrasound, however, are rarely used in children due to the prevalent notion that the limited acoustic penetrance degrades diagnostic quality. This review seeks to provide guidelines for the use of transtemporal brain contrast-enhanced ultrasound in children.
Collapse
Affiliation(s)
- Misun Hwang
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
| | | |
Collapse
|
3
|
Duyan M, Saridas A. Relation between partial arterial carbon dioxide pressure and pH value and optic nerve sheath diameter: a prospective self-controlled non-randomized trial study. J Ultrasound 2023; 26:107-116. [PMID: 35511351 PMCID: PMC10063762 DOI: 10.1007/s40477-022-00677-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/14/2022] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE This study aims to determine if there is a correlation between differences in optic nerve sheath diameter (ONSD) and changes in PaCO2 and pH values that were measured in the arterial blood gas (ABG) before and after treatment in COPD patients with acute hypercarbic respiratory failure (AHRF). MATERIALS AND METHODS This study serves as a prospective self-controlled non-randomized trial study conducted in the emergency clinic of a tertiary hospital. Forty-four patients with COPD, who were found to have acidosis and hypercarbia in ABG and had an indication for non-invasive mechanic ventilation (NIMV), were analyzed prospectively. Demographic information, vital findings, initial ABG values, the ONSD measurement (before the NIMV treatment), consciousness state, and the ABG results obtained in the second hour of the monitoring and the ONSD measurement (after the NIMV treatment) were recorded. RESULTS In this study, 13 (29.5%) of the patients were female and 31 (70.5%) were male. The age distribution was evaluated as 68.3 ± 9.2 years; the minimum age was 54 and the maximum was 91. A high level of positively significant correlation was found between the mean ONSD and PaCO2 (p < 0.0001). There is a high fit (0.72) between the mean ONSD and PaCO2. A moderate level of negatively significant correlation was found between the mean ONSD and the pH (p < 0.0001). However, there is an insignificant low fit (0.32) between the mean ONSD and the pH. CONCLUSION The ONSD changed significantly and in a highly correlated manner to acute changes in PaCO2 levels.
Collapse
Affiliation(s)
- Murat Duyan
- Department of Emergency Medicine, Emergency Medicine Specialist, Antalya Training and Research Hospital, Varlik District, Kazim Karabekir Street, 07100 Antalya, Turkey
| | - Ali Saridas
- Department of Emergency Medicine, Emergency Medicine Specialist, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
| |
Collapse
|
4
|
Tierradentro-García LO, Sridharan A, Hwang M. Transtemporal brain contrast-enhanced ultrasound in children: preliminary experience in patients without neurological disorders. J Ultrasound 2023; 26:201-210. [PMID: 36030353 PMCID: PMC10063714 DOI: 10.1007/s40477-022-00713-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/15/2022] [Indexed: 11/24/2022] Open
Abstract
AIM To evaluate the use of transtemporal brain contrast-enhanced ultrasound (CEUS) to assess cerebral blood perfusion in a cohort of children without neurological disorders. METHODS We included pediatric patients who were undergoing a clinically-indicated CEUS study. Brain scans were performed with a Siemens Sequoia scanner and a 4V1 transducer, that was placed on the left transtemporal bone. Brain scans were performed simultaneously with the images of the clinically-indicated organ of interest. Qualitative and quantitative analysis was performed to evaluate the hemispherical blood flow at the level of the midbrain during the wash-in and wash-out phases of the time-intensity curve. Clinical charts were reviewed to evaluate post-CEUS adverse events. RESULTS Five patients were evaluated (mean age 5.8 ± 5.1 years). Qualitatively, more avid enhancement in the midbrain than the cortex was observed. Structures depicted ranged between the centrum semiovale at the level of the lateral ventricles and the midbrain. A quantitative analysis conducted on four patients demonstrated less avid perfusion on the contralateral (i.e. right) side, with a mean left/right ratio ranging between 1.51 and 4.07. In general, there was a steep positive wash-in slope starting at approximately 10 s after contrast injection, reaching a peak intensity around 15-26 s on the left side, and 17-29 s on the right side. No adverse events were reported. CONCLUSION Transtemporal brain CEUS is feasible and safe in the pediatric population and allows qualitative and quantitative assessment of cerebral perfusion.
Collapse
Affiliation(s)
| | - Anush Sridharan
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Misun Hwang
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, PA, USA.
| |
Collapse
|
5
|
Ultrasound findings of acute pancreatitis in children. Pediatr Radiol 2022; 52:2342-2347. [PMID: 35554642 PMCID: PMC10103011 DOI: 10.1007/s00247-022-05381-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/09/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Studies systematically documenting US findings in children with acute pancreatitis are limited. Pancreas duct dilation is described as the most reliable finding of acute pancreatitis but this has not been rigorously examined in children. OBJECTIVE To systematically document US findings in children with acute pancreatitis and to define interobserver agreement on those findings. MATERIALS AND METHODS In this cross-sectional study we retrospectively reviewed images for all pediatric patients <18 years of age who had been prospectively enrolled in a registry of patients with index admissions for acute pancreatitis between March 2013 and July 2020. Two blinded observers (R1, R2) reviewed the first transabdominal US examination performed within 2 weeks of the pancreatitis attack for each patient. RESULTS In 141 children, US was performed at a median of 1 day (interquartile range [IQR]: 0, 1) following acute attack. Thirty-three (23%, R1) and 38 (27%, R2) children had no abnormal findings on US. Peripancreatic edema was the most frequent finding documented by both reviewers (63% R1, 54% R2). The pancreatic duct was visible in only 35% of the children and was dilated in only 12% (R1) and 14% (R2). There was substantial to almost-perfect agreement between reviewers on findings of acute pancreatitis (κ=0.62-1), including duct visibility. CONCLUSION Peripancreatic edema was the most frequently identified finding in children with acute pancreatitis, present in up to 63%, with almost perfect interobserver agreement. Duct dilation, cited in the literature as a reliable finding of acute pancreatitis, was rarely identified in our sample.
Collapse
|
6
|
Farina R, Foti PV, Iannace FA, Conti A, Pennisi I, Calcagno MC, Basile A. True congenital multicystic disease of the pancreas in the infant: a very rare case. J Ultrasound 2022; 25:721-723. [PMID: 32445079 PMCID: PMC9402859 DOI: 10.1007/s40477-020-00472-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/27/2020] [Indexed: 10/24/2022] Open
Abstract
The most frequent pancreatic cysts in patients of developmental age are pseudocysts, neoplastic cysts, posttraumatic cysts, and parasitic cysts. Retention cysts, duplication cysts, and congenital cysts are called true cysts. Among the true cysts, congenital cysts are very rare and include 1% of all pancreatic cysts. The finding of true congenital pancreatic cysts in children under 3 years represents a very rare event; less than 30 have been described in the literature. We describe the case of a 3-year-old male who came to our observation for abdominal pain and underwent an abdomen ultrasound examination. The ultrasound examination showed unilocular sub-centimeter cystic lesions, distributed throughout the pancreatic parenchyma. The patient was, therefore, not subjected to any treatment, and after a few days, the symptoms regressed spontaneously. This description probably represents the first case in the literature of "congenital multicystic disease" of the pancreas.
Collapse
Affiliation(s)
- Renato Farina
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Via Santa Sofia 78, 95123, Catania, Italy.
| | - Pietro Valerio Foti
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Via Santa Sofia 78, 95123, Catania, Italy
| | - Francesco Aldo Iannace
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Via Santa Sofia 78, 95123, Catania, Italy
| | - Andrea Conti
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Via Santa Sofia 78, 95123, Catania, Italy
| | - Isabella Pennisi
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Via Santa Sofia 78, 95123, Catania, Italy
| | - Maria Carla Calcagno
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Via Santa Sofia 78, 95123, Catania, Italy
| | - Antonio Basile
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Via Santa Sofia 78, 95123, Catania, Italy
| |
Collapse
|
7
|
Hosokawa T, Tanami Y, Sato Y, Hara T, Iwama I, Ishimaru T, Kawashima H, Oguma E. Diagnostic Accuracy of Ultrasound for Detecting Gastric or Duodenal Ulcers in Pediatric Patients. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:457-469. [PMID: 33876858 DOI: 10.1002/jum.15727] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/04/2021] [Accepted: 04/09/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Direct ultrasound imaging findings alone have low sensitivity for diagnosing duodenal (65%) and gastric ulcers (40%). This retrospective study evaluated the efficiency of ultrasound in detecting gastric/duodenal ulcers in pediatric patients through direct and indirect findings. METHODS We evaluated 244 children who underwent ultrasound and subsequent endoscopy within 4 weeks for direct and indirect imaging findings indicative of gastric/duodenal ulcers. Positive direct imaging findings revealed gastric or duodenal wall thickness >8 or 5 mm, respectively, and indirect findings revealed inflammatory changes, hyperechogenicity, and presence of lymph node around ulcers. Correspondingly, we calculated the sensitivity and specificity for diagnosing gastric/duodenal ulcers and used the Fisher's exact and Mann-Whitney U tests to compare the frequency of findings and gastroduodenal wall thicknesses in pediatric patients with gastric/duodenal ulcers. RESULTS Overall, 6 and 24 were diagnosed with gastric and duodenal ulcers, respectively. The sensitivities of direct and indirect findings were 60.0% (18/30) and 80.0% (24/30), respectively; the corresponding specificities were 98.1% (210/214) and 97.2% (208/214). The frequency of direct and indirect sonographic findings differed significantly between patients with gastric or duodenal ulcers (18/30 versus 24/30, P = .002). Gastric and duodenal wall thicknesses were greater in patients with gastric (6.6 ± 2.6 mm versus 3.6 ± 1.4 mm; P = .003) or duodenal ulcer (5.0 ± 1.4 mm versus 2.2 ± 1.0 mm; P <.0001), respectively, than in those without. CONCLUSIONS The frequency of indirect finding was greater than that of direct finding in pediatric patients with gastric/duodenal ulcers. Therefore, sonographers should carefully evaluate indirect findings around the stomach or duodenum.
Collapse
Affiliation(s)
- Takahiro Hosokawa
- Department of Radiology, Saitama Children's Medical Center, Saitama, Japan
| | - Yutaka Tanami
- Department of Radiology, Saitama Children's Medical Center, Saitama, Japan
| | - Yumiko Sato
- Department of Radiology, Saitama Children's Medical Center, Saitama, Japan
| | - Tomoko Hara
- Department of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama, Japan
| | - Itaru Iwama
- Department of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama, Japan
| | - Tetsuya Ishimaru
- Department of Surgery, Saitama Children's Medical Center, Saitama, Japan
| | - Hiroshi Kawashima
- Department of Surgery, Saitama Children's Medical Center, Saitama, Japan
| | - Eiji Oguma
- Department of Radiology, Saitama Children's Medical Center, Saitama, Japan
| |
Collapse
|
8
|
Yılmaz K, Hattapoğlu S, Şen V, Karabel M, Kan A, Yılmaz ED, Selimoglu Sen H, Yılmaz S. Evaluation of children and adolescent with cystic fibrosis by pancreatic elastography. Pediatr Int 2022; 64:e14951. [PMID: 34390069 DOI: 10.1111/ped.14951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 07/28/2021] [Accepted: 08/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cystic fibrosis (CF) is an autosomal recessively inherited disease. Clinical findings vary by age of the patient, the organ systems involved, and the severity of the CFTR gene mutation. Pancreatic and liver involvement is prominent and exocrine pancreatic insufficiency is observed in the majority of patients. Point shear wave elastography (pSWE) is a non-invasive method that can quantitatively determine tissue elasticity and stiffness. In this study, the morphological evaluation of the pancreas was performed using the pSWE technique in pediatric patients diagnosed with CF. The effectiveness of this method for the early detection of pancreatic insufficiency was investigated. METHODS Fifty-five patients with CF (24 girls, 31 boys) and 60 healthy children (29 girls, 31 boys) without any chronic diseases and who were suitable for the pSWE examination were included in the study. RESULTS The mean value of pSWE was 1.12 ± 0.16 in the healthy group and 0.97 ± 0.16 in the patients with cystic fibrosis. There was a statistically significant difference between the two groups (P < 0.001). Significant negative correlations were found between pSWE and age (r = -0.319; P = 0.018), height (r = -0.293; P = 0.03), serum glucose (r = -0.346; P = 0.01), HbA1C (r = -0.592; P = 0.02), and duration of the disease (r = -0.806; P < 0.001). CONCLUSIONS Investigating pancreatic elasticity and detecting pancreatic insufficiency using pSWE (a simple, inexpensive, and non-invasive method) in the early period before overt laboratory and clinical symptoms of EPI appear can contribute positively to long-term results in young patients with CF.
Collapse
Affiliation(s)
- Kamil Yılmaz
- Department of Pediatric Infectious Diseases, Diyarbakir, Turkey
| | | | - Velat Şen
- Department of Pediatric Pulmonology, Diyarbakir, Turkey
| | | | - Ahmet Kan
- Department of Pediatric Allergy, Diyarbakir, Turkey
| | | | | | | |
Collapse
|
9
|
Hosokawa T, Tanami Y, Sato Y, Oguma E. Comparison of the Balthazar score of acute pancreatitis between computed tomography and ultrasound in children: pitfalls of ultrasound in diagnosing and evaluating pancreatitis. J Med Ultrason (2001) 2021; 48:605-613. [PMID: 34309755 DOI: 10.1007/s10396-021-01117-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/21/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE To demonstrate the utility of ultrasound for predicting the outcome of pancreatitis in pediatric patients using the Balthazar score. METHODS Twenty-four children diagnosed with pancreatitis, who underwent computed tomography (CT) followed by ultrasound within 24 h, were included. The Balthazar score was calculated using both modalities based on the appearance of the pancreas (score 0-4). The association between the Balthazar scores with CT and ultrasound was evaluated using single linear regression analysis. To evaluate the sonographic accuracy, the ultrasound severity index and findings were compared with those of CT. Presence or absence of abnormal pancreatic parenchymal change on ultrasound was compared to the presence or absence of pancreatic necrosis on CT. The CT and sonographic findings were evaluated in eight intra-abdominal segments. RESULTS The Balthazar scores yielded by CT (2.2 ± 1.1, range 0-4) and ultrasound (2.0 ± 1.1, range 0-4) showed a significantly strong correlation (r = 0.918, p < 0.001). The accuracy of ultrasound in determining the CT Balthazar scores was 91.7% (95% confidence interval 73.0-99.0%, 22/24 patients). In the two cases with pancreatic necrosis on CT, only one case was detected as abnormal pancreatic parenchymal change. Sonographic diagnostic accuracy in the pancreatic head was lower than that in the body and tail (accuracy of the pancreatic head, body, and tail enlargement/edema = 83.3%/75%, 100%/100%, and 100%/100%, respectively). CONCLUSIONS The total CT and ultrasound severity indices were significantly correlated. Ultrasound is a useful modality for evaluating not only the initial pancreatic condition but also the severity of pediatric pancreatitis.
Collapse
Affiliation(s)
- Takahiro Hosokawa
- Department of Radiology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuo-ku, Saitama, Saitama, 330-8777, Japan.
| | - Yutaka Tanami
- Department of Radiology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuo-ku, Saitama, Saitama, 330-8777, Japan
| | - Yumiko Sato
- Department of Radiology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuo-ku, Saitama, Saitama, 330-8777, Japan
| | - Eiji Oguma
- Department of Radiology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuo-ku, Saitama, Saitama, 330-8777, Japan
| |
Collapse
|
10
|
Brillantino C, Rossi E, Pirisi P, Gaglione G, Errico ME, Minelli R, Menna BF, Zeccolini R, Zeccolini M. Pseudopapillary solid tumour of the pancreas in paediatric age: description of a case report and review of the literature. J Ultrasound 2021; 25:251-257. [PMID: 33895967 DOI: 10.1007/s40477-021-00587-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/13/2021] [Indexed: 12/01/2022] Open
Abstract
Pseudopapillary solid tumour of the pancreas is a rare neoplasm that mainly affects young women in the second and third decade of life and less frequently children; originates from the exocrine component of the pancreas; and is characterized by slow growth, low potential for malignancy, and excellent prognosis following complete surgical resection. The tumour often presents as an asymptomatic abdominal mass that is accidentally detected during radiological investigations performed for other reasons. In this article, we report the clinical case of a 10-year-old girl who came to our observation for pain in the left hypochondrium, which had arisen for a week following a trauma; the imaging methods revealed a voluminous expansive pancreatic formation in the abdomen; on histological examination, the mass was a solid pseudopapillary tumour. Furthermore, we present a review of the literature aimed at highlighting the salient features of this neoplasm in paediatric age.
Collapse
Affiliation(s)
- Carmela Brillantino
- Unit of Radiology and Ultrasound, Pausilipon Hospital, A.O.R.N. Santobono-Pausilipon, Naples, Italy
| | - Eugenio Rossi
- Unit of Radiology and Ultrasound, Pausilipon Hospital, A.O.R.N. Santobono-Pausilipon, Naples, Italy
| | - Pietro Pirisi
- Surgical Oncology Unit, Pausilipon Hospital, A.O.R.N. Santobono Pausilipon, Naples, Italy
| | - Giovanni Gaglione
- UOC Paediatric Surgery A.O.R.N. Santobono-Pausilipon, Santobono Hospital, Naples, Italy
| | - Maria E Errico
- Unit of Pathological Anatomy, Pausilipon Hospital, A.O.R.N. Santobono-Pausilipon, Naples, Italy
| | - Rocco Minelli
- Department of Life and Health "V. Tiberio", University of Molise, Francesco De Sanctis st 1, 86100, Campobasso, Italy.
| | - Biagio F Menna
- Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini 5, 80131, Naples, Italy
| | | | - Massimo Zeccolini
- Unit of Radiology, Santobono Hospital, A.O.R.N. Santobono-Pausilipon, Naples, Italy
| |
Collapse
|
11
|
Duodenal hematoma in pediatric age: a rare case report. J Ultrasound 2020; 25:349-354. [PMID: 33247814 DOI: 10.1007/s40477-020-00545-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 11/15/2020] [Indexed: 12/16/2022] Open
Abstract
In pediatric age, duodenal hematoma is rare and generally occurs following a closed abdominal trauma due to the crushing of the duodenum against the rigid plane of the spine; it rarely follows anticoagulant therapy, pancreatitis, bleeding disorders, vasculitis, tumors or upper digestive endoscopy. Duodenal hematoma is a rare cause of obstruction of the upper gastrointestinal tract and acute pancreatitis, and the diagnosis is sometimes difficult and late. On the other hand, the identification of the pathology in its initial stages allows the young patients to be subjected to a conservative treatment that resolves the issue most of the time, thus avoiding surgery. In this article we describe an unusual case of duodenal hematoma, following esophagus-gastro-duodenoscopy, in a 12-year-old boy with Di George syndrome.
Collapse
|
12
|
A comparative study of the pancreas in pediatric patients with cystic fibrosis and healthy children using two-dimensional shear wave elastography. J Ultrasound 2020; 23:535-542. [PMID: 32034705 DOI: 10.1007/s40477-020-00432-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 01/23/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To compare sonographic parameters of the pancreas between healthy children and pediatric cystic fibrosis (CF) patients with pancreatic involvement using shear wave elastography (SWE) and to investigate the efficacy of SWE in the diagnosis of pancreatic involvement in pediatric CF patients. METHODS The pancreas was evaluated in 38 patients with CF and 38 healthy children using conventional B-mode ultrasonography (US) and two-dimensional (2D)-SWE. RESULTS The pancreatic 2D-SWE values of the CF group were significantly lower than those of the healthy control group (1.01 ± 0.16 vs. 1.31 ± 0.01 m/s for the head, 1.03 ± 0.05 vs. 1.28 ± 0.08 m/s for the pancreatic body, and 1.02 ± 0.05 vs. 1.30 ± 0.10 m/s for the tail; p < 0.005 for all the comparisons). When the threshold values were obtained for the pancreatic head, body, and tail segments for the differentiation of the CF patients and healthy controls, the sensitivity of the test was determined as 81.5%, 76.3%, and 73.3%, respectively, and the specificity as 97.3%, 100%, and 100%, respectively. When the patients were divided into two groups based on the presence of B-mode US characteristics (homogeneity, sharp demarcation, and hyperechoic pancreas), there was a significant difference in the 2D-SWE values of the pancreatic head between the patients with and the patients without these characteristics (p = 0.048 for homogeneity, p = 0.021 for sharp demarcation, and p = 0.006 for hyperechoic pancreas). CONCLUSION The measurement of 2D-SWE values was found to be an easily applicable non-invasive test with high sensitivity and specificity for the demonstration of changes in the pancreas of pediatric CF patients.
Collapse
|
13
|
Di Serafino M, Gioioso M, Severino R, Esposito F, Vezzali N, Ferro F, Pelliccia P, Caprio MG, Iorio R, Vallone G. Ultrasound findings in paediatric cholestasis: how to image the patient and what to look for. J Ultrasound 2019; 23:1-12. [PMID: 30756259 DOI: 10.1007/s40477-019-00362-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 01/24/2019] [Indexed: 02/07/2023] Open
Abstract
Paediatric biliary tract and gallbladder diseases include a variety of entities with a wide range of clinical presentations. Cholestasis represents an impaired secretion of bilirubin by hepatocytes, manifesting with high blood levels of conjugated bilirubin and jaundice. Various causes may be involved, which can be recognised analysing blood tests and hepatobiliary imaging, while sometimes liver biopsy or surgery may be necessary. High-resolution real-time ultrasonography is an important tool for differentiation of obstructive and non-obstructive causes of jaundice in infants and children. In this paper, we briefly review the normal anatomy and the ultrasound aspects of main pathologies affecting gallbladder and biliary tree in neonatal and paediatric age.
Collapse
Affiliation(s)
- Marco Di Serafino
- Department of Radiology, "Antonio Cardarelli" Hospital, Antonio Cardarelli st 9, 80131, Naples, Italy.
| | - Matilde Gioioso
- Department of Radiology, "San Carlo Regional Hospital", Potenza, Italy
| | - Rosa Severino
- Department of Radiology, "San Carlo Regional Hospital", Potenza, Italy
| | - Francesco Esposito
- Department of Radiology, "Santobono-Pausilipon" Children Hospital, Naples, Italy
| | - Norberto Vezzali
- Department of Radiology, "Regional Hospital of Bolzano", Bolzano, Italy
| | - Federica Ferro
- Department of Radiology, "Regional Hospital of Bolzano", Bolzano, Italy
| | | | - Maria Grazia Caprio
- Institute of Biostructure and Bioimaging IBB, Italian National Research Council CNR, Rome, Italy
| | - Raffaele Iorio
- Department of Paediatrics, "Federico II" University Hospital, Naples, Italy
| | - Gianfranco Vallone
- Department of Radiology, "Federico II" University Hospital, Naples, Italy
| |
Collapse
|