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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jul 28, 2016; 8(7): 656-667
Published online Jul 28, 2016. doi: 10.4329/wjr.v8.i7.656
Abdominal ultrasonography of the pediatric gastrointestinal tract
Heather I Gale, Michael S Gee, Sjirk J Westra, Katherine Nimkin
Heather I Gale, Michael S Gee, Sjirk J Westra, Katherine Nimkin, Department of Radiology, Division of Pediatric Radiology, Massachusetts General Hospital, Boston, MA 02114, United States
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Katherine Nimkin, MD, Department of Radiology, Division of Pediatric Radiology, Massachusetts General Hospital, 55 Fruit Street, Ellison 237, Boston, MA 02114, United States. knimkin@partners.org
Telephone: +1-617-7244207 Fax: +1-617-7268360
Received: January 22, 2016
Peer-review started: January 23, 2016
First decision: March 24, 2016
Revised: April 11, 2016
Accepted: June 1, 2016
Article in press: June 3, 2016
Published online: July 28, 2016
Processing time: 184 Days and 16.1 Hours
Abstract

Ultrasound is an invaluable imaging modality in the evaluation of pediatric gastrointestinal pathology; it can provide real-time evaluation of the bowel without the need for sedation or intravenous contrast. Recent improvements in ultrasound technique can be utilized to improve detection of bowel pathology in children: Higher resolution probes, color Doppler, harmonic and panoramic imaging are excellent tools in this setting. Graded compression and cine clips provide dynamic information and oral and intravenous contrast agents aid in detection of bowel wall pathology. Ultrasound of the bowel in children is typically a targeted exam; common indications include evaluation for appendicitis, pyloric stenosis and intussusception. Bowel abnormalities that are detected prenatally can be evaluated after birth with ultrasound. Likewise, acquired conditions such as bowel hematoma, bowel infections and hernias can be detected with ultrasound. Rare bowel neoplasms, vascular disorders and foreign bodies may first be detected with sonography, as well. At some centers, comprehensive exams of the gastrointestinal tract are performed on children with inflammatory bowel disease and celiac disease to evaluate for disease activity or to confirm the diagnosis. The goal of this article is to review up-to-date imaging techniques, normal sonographic anatomy, and characteristic sonographic features of common and uncommon disorders affecting the gastrointestinal tract in children.

Keywords: Ultrasound; Pediatric; Gastrointestinal tract; Bowel; Enteritis

Core tip: Ultrasound is increasingly utilized to evaluate gastrointestinal disorders in children. Recent improvements in ultrasound technique allow detailed evaluation of bowel pathology. We present a comprehensive review of bowel pathology in children with emphasis on ultrasonographic technique and findings. This review will describe the variety of sonographic techniques available to optimize assessment of bowel disease and sonographic features of normal bowel will be described. Common and uncommon disorders of bowel in children will include congenital, acquired, inflammatory and neoplastic processes.