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

Hyun Seok Park; Ju Hee We; Jae Hong Park

doi:10.5223/kjpgn.2011.14.2.141

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Park, We, and Park: Usefulness of Ultrasonographic Examination by a Pediatrician in Children with Abdominal Pain

Original Article

Gastrointestinal Tract

Korean Journal of Pediatric Gastroenterology and Nutrition

Korean Journal of Pediatric Gastroenterology and Nutrition 2011; 14(2): 141-147.

Published online: 30 June 2011

DOI: https://doi.org/10.5223/kjpgn.2011.14.2.141

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

Hyun Seok Park, M.D., Ju Hee We, M.D., Jae Hong Park, M.D.

Department of Pediatrics, College of Medicine, Pusan National University, Busan, Korea.

Corresponding author (jhongpark@pusan.ac.kr)

Received 7 February 2011 Revised 27 March 2011 Accepted 31 March 2011

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-Shönlein 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.

Keywords: Abdominal pain, Child, Ultrasonography, Pediatrician

Figures and Tables

Fig. 1

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

Table 1

Ultrasonographic Findings

^*GB stone, ovarian cyst, renal cyst, hydronephrosis, ascites, aerophagia, nutcracker syndrome.

Table 2

Final Diagnosis of Patients with Normal Findings on Ultrasonography

^*Tonsillitis, bronchitis, erosive gastritis, infectious mononucleosis, esophageal reflux, Crohn's disease, constipation, anorexia nervosa.

Table 3

Diagnosis of Intestinal Mural Thickening

Table 4

Final Diagnosis in Patients with Obscure Findings on the Ultrasonographic Examination

^*GB stone, pancreatic pseudocyst, splenic torsion, mesenteric lymphadenitis, small bowel intussusception, choledochal cyst, no remarkable abnormal findings.

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