Pediatric abdomen

A free gallery of high-resolution, ultrasound, color doppler and 3D images

Ultrasound images of pediatric abdomen:

Ectopic kidney or Renal ectopia:

1) Pelvic kidney in neonate:

This female neonate presented with imperforate anus. Sonography reveals normally located right kidney. However the left kidney is not visualized in left renal fossa. Ultrasound images reveal a pelvic kidney that appears somewhat rounded, located posterior and superior to the bladder. The renal pyramids of both kidneys appear echogenic suggestive of early nephrocalcinosis. The uterus of this neonate was not visualized well. Color doppler imaging shows the vascularity of the pelvic kidney. Images taken using a Toshiba Xario machine.

Reference: http://www.thefetus.net/page.php?id=549 (a good article on pelvic kidney, with free images).

2) Nephrocalcinosis in neonates:

These ultrasound images of neonatal kidneys show- markedly echogenic renal pyramids, bilaterally, with chief involvement of the tips suggestive of medullary nephrocalcinosis. Such nephrocalcinosis in neonates usually follows long term parenteral therapy or due to use of certain drugs notably gentamicin and furosemide. It can also be caused by low fluid intake in the neonate and due to oxygen dependency. This condition, in neonates, usually resolves following correction of the etiological factors. Case courtesy of Joe Antony, MD, India. Images taken using a Toshiba Xario machine.

Also see: http://www.ultrasound-images.com/renal-calculi.htm (where I describe nephrocalcinosis in adults).

3) Communicating hydrocele in neonate:

This neonate showed a swelling of the Rt. scrotum. Sonography of the pelvis and scrotum revealed a right sided hydrocele (seen as a hypoechoic collection surrounding the right testes). The hydrocele also appears to communicate (arrows) with the abdomen through a patent processus vaginalis. This patent communication may cause a hernia or hydrocele to persist in infants. These ultrasound images are diagnostic of communicating hydrocele.

Images courtesy of Dr. Ravi Kadasne, Radiologist, UAE, who used a Philips IU 22 ultrasound machine, here.

Reference: http://www.emedicine.com/ped/topic1037.htm (free article).

4) Bilateral communicating hydrocele in neonate:

The above ultrasound images show gross bilateral communicating hydrocele in a neonate, which was found to have Hydrops fetalis in utero. Note the presence of ascitic fluid with communication with the hydrocele (arrow in figure below).

5) Persistent vesico-urachal diverticulum in child:

This 4 yr. old male child had severe pain in the lower abdomen. Sonography revealed a tubular hypoechoic structure leading to the urinary bladder from just below the umbilicus. These ultrasound images suggest a diagnosis of inflammation of the persistent vesico-urachal diverticulum. The urachus is a duct that leads from the urinary bladder to the umbilicus in the fetus. Peristence of the urachal duct can present as a sinus or diverticulum in children. Ultrasound images taken using a Philips IU 22 machine by Dr. Ravi Kadasne. UAE.

Reference: 1) http://www.emedicine.com/ped/topic1402.htm (free article)

2) http://www.nlm.nih.gov/medlineplus/ency/article/002993.htm

6) Sonography of renal fungal balls in neonate:

The above ultrasound images (LEFT) shows 2 echogenic, rounded, non-shadowing mass lesions in the renal pelvis of right kidney. The left kidney of the neonate shows pelvicalyceal dilation with a few echogenic foci in the calyces. The neonate was undergoing prolonged antibiotic therapy following sepsis after preterm delivery.

Following are ultrasound images after 2 weeks:

The follow up ultrasound images of the same neonate after 2 weeks show presence of the more rounded masses in the right kidney which also shows mild dilation of the renal pelvis. Smaller lesions are seen in the left kidney with pelvicalyceal dilation. The right kidney also shows rounded lesions in the pelvi-ureteric junction region. The urinary bladder also shows small rounded lesions floating within it. Such lesions are usually due to fungal balls or blood clots. Since blood clots in the renal collecting system usually dissolve after a few days, these ultrasound images suggest fungal balls in the kidneys and urinary bladder. The dilated pelvi-calyces of both kidneys suggest obstruction produced by the fungal balls in the collecting system.

Reference: http://radiology.rsnajnls.org/cgi/reprint/142/2/473.pdf

7) Sonography of neonatal uterus:

The above 2 ultrasound images show neonatal uterus in a female. The endometrial cavity (uterine cavity) shows small hypoechoic collections within it suggestive of fluid. A small amount of fluid may normally be seen in a perfectly normal female baby and should be of no clinical concern. Both these sonographic images are courtesy of Mr. Shlomo Gobi, Israel.

8) Gall bladder calculi in neonate:

The above ultrasound images show a long section through a neonatal gall bladder (GB). Multiple echogenic lesions are seen in the lumen of the neonate's gall bladder suggestive of numerous gall stones/GB calculi. Presence of gall bladder calculi in the last trimester of fetus and immediately after birth is a known occurrence. However, this type of gallstones in the neonate are of little clinical significance, as follow up sonography usually shows resolution of the condition. Ultrasound images are by Joe Antony, MD, using a Toshiba Xario ultrasound system..

Reference: http://emedicine.medscape.com/article/927522-overview

9) Cirrhosis of liver and hepatorenal syndrome in neonate:

This female neonate presented with abdominal distension and oliguria. Sonography of the neonatal abdomen showed evidence of moderate ascites and echogenic, nodular liver. The liver showed moderate hepatomegaly with nodularity best seen outlined by the fluid in peritoneal cavity. The right kidney was also markedly echogenic as was the left kidney (not shown here). Color Doppler ultrasound image also shows mildly dilated portal vein (6mm. at porta hepatis). These ultrasound findings suggest advanced cirrhosis of the liver with associated renal failure in this neonate (hepato-renal failure). The cause of the cirrhosis was not determined and this condition was labeled idiopathic cirrhosis with multi-organ failure.

Reference: http://www.jultrasoundmed.org/cgi/reprint/19/4/285.pdf

http://pediatrics.aappublications.org/cgi/content/abstract/33/5/721

10) Neuroblastoma in neonate:

The above ultrasound and color Doppler images show multiple echogenic, poorly vascular masses throughout the liver in this neonate. The left kidney shows a poorly defined mass in the upper pole. The right kidney appears normal. A provisional diagnosis of neuroblastoma was made on these sonographic findings. However, it was felt that CT scan would be of better diagnostic importance. CT scan images of this neonate are shown below (coronal and sagittal reformatted images):

The CAT scan images of this neonate confirmed the presence of a left suprarenal mass, which was hypodense and poorly enhancing. The left kidney was also found to be displaced laterally and downwards. These findings confirmed a left adrenal neuroblastoma with metastases to the liver. The liver shows massive hepatomegaly.

Reference: http://emedicine.medscape.com/article/411694-imaging

Your Ad Here

This page was last edited on: Tuesday August 17, 2010 03:22 PM

Scan centre: ULTRASCAN CENTRE, AL-FIA Building, Opp. Reserve Bank of India, ERNAKULAM,

COCHIN (KOCHI)- 682018, KERALA.

Ph: (Off.) 91-484-2403058, (Residence) 91-484-2311416, (Cell) 91- 93886-23088

Contact: joe@ultrasound-images.com or drjoea (at) gmail.com