Etiology of non-traumatic acute abdomen in pediatric emergency departments

Figure 1 A nodular calcified appendicolith (arrow) in the right lower abdominal quadrant.

Figure 2 Acute appendicitis. A: A blind-ending, non-compressible tubular structure (arrows); an echogenic appendicolith with an acoustic shadow over tip (arrowheads); B: An enlargement of whole diameter of the appendix (arrows) with enhancement and thickening of the appendiceal wall associated with intraluminal fluid collections.

Figure 3 ‘‘Pseudokidney’’ sign (A) and ‘‘target sign (arrow)” (B) on ultrasonography.

Figure 4 A concentric ring of the ileum (arrows) from ileo-colic intussusception.

Figure 5 Henoch-Schonlein purpura. A: Sagittal ultrasound image shows more moderate wall thickening of small bowel with ascites; B: Coronal computed tomography shows long segments of thickened, enhancing, fluid filled small bowel (arrows).

Figure 6 Bacterial enteritis. A: Ultrasound showing marked wall thickening of the cecum (arrow) in a child with right lower quadrant pain, which returned to normal; B: 4 d later. Stool cultures were positive for enterohemorrhagic Escherichia coli.

Figure 7 Meckel’s diverticulum. A: Small-bowel obstruction shown on computed tomography (CT) in an 18-year-old boy with pathologically proven Meckel’s diverticulum; B: CT image in an 11-year-old girl shows intussusception (arrows) as a bowel loop containing alternating rings of attenuation. Note dilated proximal small bowel (D) and collapsed terminal ileum (arrowheads).

Figure 8 Mesenteric adenitis. A: Ultrasound shows multiple enlarged lymph nodes (arrowheads) at the base of mesentery, anterior to the inferior vena cava; B: Computed tomography of the abdomen showing clustering of mesenteric lymph nodes with largest diameter of about 11.2 mm (black arrow) and thickening of the bowel wall of terminal ileum.