Imaging Non-traumatic Abdominal Emergencies in Pediatric Patients
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1 Imaging Non-traumatic Abdominal Emergencies in Pediatric Patients
2 Vittorio Miele Margherita Trinci Editors Imaging Non-traumatic Abdominal Emergencies in Pediatric Patients
3 Editors Vittorio Miele Department of Emergency Radiology S. Camillo Hospital Rome Italy Margherita Trinci Department of Emergency Radiology S. Camillo Hospital Rome Italy ISBN ISBN (ebook) DOI / Library of Congress Control Number: Springer International Publishing Switzerland 2016 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG Switzerland The registered company address is Gewerbestrasse 11, 6330 Cham, Switzerland
4 Dedicated to our Colleagues, who are true professionals, dear friends, work and life mates
5 Foreword Pediatric radiology, despite being recognized as an imaging subspecialization, in many countries does not have a strong presence in either undergraduate or postgraduate radiology education programs. The aim of this book is to offer a reference text for radiologists and student radiologists working within general imaging departments and highlights unique aspects of pediatric radiology practice. In many cases, general radiologists have inadequate contact with pediatric radiology during their course of training. Pediatricians and surgeons, who wish to understand the indications, limitations, and clinical applications of imaging will also gain value from this book. Usually, pediatricians lack not only the ability to interpret the images, but also awareness about the importance of a finding for the next step toward a diagnosis and thus for treatment. The editors, Dr. V. Miele and Dr. M. Trinci, have been very efficacious in engaging several national specialists in the field, to contribute to different chapters and I would like to congratulate them for the quick and brilliant harmonization of the editorial preparation of this second book on emergencies. The first one was Imaging Trauma and Polytrauma in Pediatric Patients (Springer, 2015). The goal of this second book is to deliver again a comprehensive text on the clinical application of radiology in a pediatric population. As in the first book, this goal is obtained by providing information on ways to enhance the performance and interpretation of images, and to avoid technical and interpretative errors: far greater emphasis is placed on radiation-dose reduction techniques. The initial chapter provides exhaustive instruction for studying neonatal acute abdomen, while reducing radiation exposure and presents hands-on protocols for imaging. In the succeeding chapters, abnormal findings are described and illustrated for pediatric acute abdomen, neonatal and pediatric GU emergencies, and critical issues in pediatric emergencies. Importantly, when writing this text, the authors tried to provide a description of all pediatric imaging techniques or provide answers to all imaging dilemmas, even if many of these will be dependent upon local expertise, radiographic equipment, and availability of alternative imaging modalities. The diagnostic strategies used for children differ from those used for adults in many points. Children and adolescents are not simply small adults; they suffer from different diseases and require different treatments. The same is true where imaging is concerned. The diagnostic approaches using vii
6 viii Foreword identical diagnostic instruments are different; the care prior to, during, and following the examination differs from that of adults. One of the most important aspects is radiation protection, as children are particularly sensitive to ionizing radiation and, with their longer life expectancy, can also expect to accumulate a higher dose from natural and artificial above all medical causes. The latter increase the individual risk of malignant diseases. The best radiation protection is the justification of an examination employing ionizing radiation (X-rays, CT scan). This is realized by establishing strict indications and, on the other hand, if possible, by replacing ultrasonography or magnetic resonance imaging for X-rays or CT. In addition to the aspect of radiation protection, however, there is also a physical reason for the great value of ultrasonography in pediatric radiology. High frequencies allow for high diagnostic quality but results in less penetration depth. Given the lesser body volume of children, higher frequencies can be used in them. This is one of the reasons why ultrasonography is of greater value in pediatric radiology than in adult radiology. Therefore, diagnostic flow charts produced from adult imaging cannot be directly applied to pediatric radiology. As in the first highly successful book, the main emphasis is put on the actual role of cross-sectional imaging methods in conjunction with standard radiography. This volume covers our current knowledge and new visions into the crucial role that radiological imaging plays in the appropriate management of infants and children with acute abdominal diseases. In summary, this book strives to update the current knowledge on nontraumatic abdominal emergencies in children. Equipment continues to improve; new technologies continue to develop; and the clinical applications of radiology continue to evolve. It is necessary that radiologists meet the challenge of applying these new technologies and applications to the care of pediatric patients. I am confident that this book will again inspire great interest among both general and specialized pediatric radiologists, as well as among neonatologists, pediatricians, and pediatric surgeons. Paolo Tomà Diagnostic Imaging Department, Children s Hospital Bambino Gesù, S. Onofrio Square, Rome, Italy
7 Contents Part I Neonatal Acute Abdomen 1 Intestinal Stenosis and Atresia Vittorio Miele, Claudia Lucia Piccolo, Valeria Saracco, Maria Napoletano, Margherita Trinci, and Luca Brunese 2 Intestinal Malrotation and Volvulus Viola Valentini, Claudia Lucia Piccolo, Maria Napoletano, Rosanna Mamone, Massimo Zeccolini, and Vittorio Miele 3 Meconium Ileus Margerita Trinci, Antonio Alessandro Pallottino, Claudia Lucia Piccolo, Francesca De Narda, Cinzia Orazi, and Vittorio Miele 4 Necrotizing Enterocolitis Margherita Trinci, Claudia Lucia Piccolo, Antonio Alessandro Pallottino, Francesco Esposito, Massimo Zeccolini, and Vittorio Miele 5 Hirschsprung s Disease Domenico Barbuti 6 Complications of Neonatal Abdominal Devices in Emergency Riccardo Ferrari, Antonio Alessandro Pallottino, Claudia Lucia Piccolo, Maria Napoletano, Margherita Trinci, and Vittorio Miele 7 Biliary Atresia and Choledochal Cyst Lidia Monti, Amato Infante, and Marco Salsano Part II Pediatric Acute Abdomen 8 Hypertrophic Pyloric Stenosis (HPS) Margherita Trinci, Claudia Lucia Piccolo, Antonio Alessandro Pallottino, Michele Galluzzo, Eugenio Rossi, Massimo Zeccolini, and Vittorio Miele ix
8 x Contents 9 Intestinal Intussusception Michele Galluzzo, Francesco Gaudino, Riccardo Palliola, Eugenio Rossi, Massimo Zeccolini, and Margherita Trinci 10 Acute Appendicitis Grazia Loretta Buquicchio, Gavina Cuneo, Stefano Giannecchini, Caterina Pizzi, Carmelo Rende, and Margherita Trinci 11 Meckel s Diverticulum Maria Elena Latini, Sara Riccioni, Maria Napoletano, Nicola Recchia, and Michele Scialpi Part III Neonatal and Pediatric GU Emergencies 12 Neonatal Adrenal Hemorrhage Margherita Trinci, Caterina Maria Trinci, Michele Galluzzo, Eugenio Rossi, Massimo Zeccolini, and Vittorio Miele 13 Hydrometrocolpos: Hematocolpos/Colpo-hematometra Stefania Ianniello, Maria Gabriella Merola, Marinella Nanni, Cinzia Orazi, Paolo Schingo, and Margherita Trinci 14 Ovarian Torsion Marinella Nanni, Maria Gabriella Merola, Stefania Ianniello, Cinzia Orazi, Paolo Maria Schingo, and Margherita Trinci 15 Complications of Urachal Remnants Maria Elena Latini, Sara Riccioni, Nicola Recchia, Maria Napoletano, and Michele Scialpi 16 Nephro-urolithiasis Francesca Pancrazi, Giulia Angelini, Laura Turturici, Laura Tasciotti, Claudio Defilippi, and Michele Tonerini 17 Acute Pyelonephritis Alessandra Scionti, Piercarlo Rossi, Pietro Gulino, Alessandro Semeraro, Claudio Defilippi, and Michele Tonerini 18 Hydronephrosis and Pyonephrosis Silvia Lorenzi, Francesca Fanti, Giacomo Aringhieri, Marco Di Maurizio, Claudio Defilippi, and Michele Tonerini 19 Posterior Urethral Valves Cinzia Orazi, Antonio Maria Zaccara, Massimiliano Silveri, and Paolo Maria Schingo 20 Acute Scrotum Riccardo Palliola, Antonio Alessandro Pallottino, Michele Galluzzo, Stefania Ianniello, Viola Valentini, and Margherita Trinci
9 Contents xi Part IV Critical Issues in Pediatric Emergencies 21 Abdominal Neoplasm: Clinical Onset in Emergency Setting Barbara Sessa, Roberto Castellucci, Antonio Solazzo, Eugenio Rossi, Massimo Zeccolini, and Sandro Sironi 22 MDCT and MRI Protocols in Pediatric Non-traumatic Abdominal Emergencies Michele Scialpi, Maria Elena Latini, Sara Riccioni, Valeria Rondoni, Riccardo Torre, Lucia Mariotti, Alfredo D Andrea, Raffaele Schiavone, and Lucia Manganaro 23 The Radioprotection of the Child in Emergency Radiology Andrea Magistrellli 24 Informed Consent and Medicolegal Issues Related to the Imaging of Pediatric Non-traumatic Emergencies Antonio Pinto, Giuseppe Lo Re, Fabio Pinto, and Luigia Romano
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