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Miyata E, Jimbo K, Kyodo R, Suzuki M, Kudo T, Shimizu T. Differentiation of Yersinia enterocolitica enteritis from other bacterial enteritides by ultrasonography: A single-center case-control study. Pediatr Neonatol 2022; 63:262-268. [PMID: 35277366 DOI: 10.1016/j.pedneo.2021.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/15/2021] [Accepted: 12/26/2021] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND The diagnosis of Yersinia enterocolitica (Ye) enteritis is not easy because detection from stool culture is more difficult for Ye than for other bacterial enteritides. The establishment of characteristic ultrasonographic findings for Ye enteritis would help improve the detection rate of Ye enteritis along with performance of several cold cultures. This would facilitate appropriate selection of antibiotics based on antimicrobial susceptibility testing and contribute to a more accurate understanding of local public health. This study aimed to retrospectively compare ultrasonographic findings and clinical features between children with Ye enteritis and other bacterial enteritides. METHODS We identified patients treated for Ye enteritis (Ye group; n = 27) or other bacterial enteritides (Other enteritis group; n = 29) between 2014 and 2018. Ultrasonographic findings (including mean maximum diameter and mean major-minor axis ratio of ileocecal lymph nodes, wall thickness of the terminal ileum, and presence of a pericecal hyperechoic region), clinical symptoms, and laboratory findings at first visit were compared between groups. RESULTS No difference in mean maximum diameter of ileocecal lymph nodes was seen between groups. However, mean major-minor axis ratio of ileocecal lymph nodes was lower in the Ye group than in the Other enteritis group (p < 0.001). Presence of a pericecal hyperechoic region was more frequent in the Ye group than in the Other enteritis group (p < 0.001). The combined presence of a mean ileocecal lymph node major-minor axis ratio <1.51 and a pericecal hyperechoic region offered 100% sensitivity. CONCLUSION Characteristic ultrasonographic findings identified in this study may improve ultrasonographic differentiation of Y. enterocolitica enteritis from other bacterial enteritides.
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Affiliation(s)
- Eri Miyata
- Department of Pediatrics and Adolescent Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Keisuke Jimbo
- Department of Pediatrics and Adolescent Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
| | - Reiko Kyodo
- Department of Pediatrics and Adolescent Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Mitsuyoshi Suzuki
- Department of Pediatrics and Adolescent Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Takahiro Kudo
- Department of Pediatrics and Adolescent Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics and Adolescent Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
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Identifying threshold sizes for enlarged abdominal lymph nodes in different age ranges from about 200,000 individual's data. Sci Rep 2021; 11:1762. [PMID: 33469140 PMCID: PMC7815733 DOI: 10.1038/s41598-021-81339-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 01/05/2021] [Indexed: 11/13/2022] Open
Abstract
The threshold size for enlarged abdominal lymph nodes (E-ALNs), a common pediatric disorder, has yet to be standardized. According to the maximum short-axis diameter, this study divided ALNs into Grade A (≥ 10 mm), Grade B (8–10 mm), Grade C (5–8 mm), and Grade D (< 5 mm, normal). To identify the threshold size for E-ALNs, the prevalence of each grade was compared between asymptomatic individuals and symptomatic (e.g., abdominal pain) individuals without other diseases (e.g., appendicitis) that could explain the symptoms for different ages using data from > 200,000 individuals. The results showed the following: (1) For ages 1–3 years, the recommended threshold size is 8 mm, as the differences in the prevalence between the two groups were nonsignificant for Grade C but significant (p < 0.05) for both Grades A and B. (2) For ages 3–14 years, the recommended threshold size is 5 mm, as the differences between the two groups were significant (p < 0.05) for Grades A, B, and C. (3) The prevalence of Grades A, B, and C was very low for ages 0–1 years and high for ages 1–6 years. (4) The prevalence for males was generally higher than that for females for Grades A and B.
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Quitadamo P, Giannetti E, Andreozzi M, Mancusi V, Caprio MG, Brambilla A, Esposito F, Vallone G, Siani P, Staiano A. Clinical significance and sonographic evolution of enlarged abdominal lymph nodes in children. Acta Paediatr 2019; 108:1857-1860. [PMID: 30929258 DOI: 10.1111/apa.14804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 02/25/2019] [Accepted: 03/27/2019] [Indexed: 11/29/2022]
Abstract
AIM Paediatric evidence about the clinical implications of enlarged abdominal lymph nodes (EALN) is not univocal. The main purpose of our study was to evaluate the clinical significance and the morphological evolution of enlarged abdominal nodes in children with recurrent abdominal pain. METHODS All children with recurrent abdominal pain diagnosed with EALN were enrolled at the involved centres between September 2017 and June 2018. Number, size, localisation, shape and architecture of nodes were accurately recorded along with clinical and laboratory data at enrolment and after three and six months. RESULTS A total of 38 children were enrolled. After the six-month study period, 58% of them had lymph nodes reduced in size, 13% had unchanged lymph nodes, and 29% had lymph nodes increased in size. Overall, we observed a gradual, albeit slight reduction in the average size of enlarged nodes over the six-month period. The extent of size changes was not correlated with any clinical parameter. CONCLUSION Our data suggest that EALN are a non-specific finding, which is not worth a change in the diagnostic and therapeutic management of children with abdominal pain.
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Affiliation(s)
- Paolo Quitadamo
- Department of Translational Medical Science Section of Pediatrics “Federico II” University of Naples Naples Italy
- Department of Pediatrics A.O.R.N. Santobono‐Pausilipon Naples Italy
| | - Eleonora Giannetti
- Department of Translational Medical Science Section of Pediatrics “Federico II” University of Naples Naples Italy
| | - Marialuisa Andreozzi
- Department of Translational Medical Science Section of Pediatrics “Federico II” University of Naples Naples Italy
| | - Valeria Mancusi
- Department of Advanced Biomedical Sciences “Federico II” University of Naples Naples Italy
| | - Maria Grazia Caprio
- Institute of Biostructure and Bioimaging IBB Italian National Research Council CNR Naples Italy
| | - Andrea Brambilla
- Department of Translational Medical Science Section of Pediatrics “Federico II” University of Naples Naples Italy
| | | | - Gianfranco Vallone
- Department of Advanced Biomedical Sciences “Federico II” University of Naples Naples Italy
| | - Paolo Siani
- Department of Pediatrics A.O.R.N. Santobono‐Pausilipon Naples Italy
| | - Annamaria Staiano
- Department of Translational Medical Science Section of Pediatrics “Federico II” University of Naples Naples Italy
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Silva EJDCE, Silva GAPD. Local behavior and lymph node metastases of Wilms' tumor: accuracy of computed tomography. Radiol Bras 2014. [DOI: 10.1590/s0100-39842014000100007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To evaluate the accuracy of computed tomography for local and lymph node staging of Wilms' tumor. Materials and Methods Each case of Wilms' tumor was evaluated for the presence of abdominal lymph nodes by a radiologist. Signs of capsule and adjacent organ invasion were analyzed. Surgical and histopathological results were taken as the gold standard. Results Sensitivity was 100% for both mesenteric and retroperitoneal lymph nodes detection, and specificity was, respectively, 12% and 33%, with positive predictive value of 8% and 11% and negative predictive value of 100%. Signs of capsular invasion presented sensitivity of 87%, specificity of 77%, positive predictive value of 63% and negative predictive value of 93%. Signs of adjacent organ invasion presented sensitivity of 100%, specificity of 78%, positive predictive value of 37% and negative predictive value of 100%. Conclusion Computed tomography tumor showed low specificity and low positive predictive value in the detection of lymph node dissemination. The absence of detectable lymph nodes makes their presence unlikely, and likewise regarding the evaluation of local behavior of tumors.
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Raposo Rodríguez L, Anes González G, García Hernández J, Torga Sánchez S. Usefulness of ultrasonography in children with right iliac fossa pain. RADIOLOGIA 2012. [DOI: 10.1016/j.rxeng.2011.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Raposo Rodríguez L, Anes González G, García Hernández JB, Torga Sánchez S. [Usefulness of ultrasonography in children with right iliac fossa pain]. RADIOLOGIA 2011; 54:137-48. [PMID: 22195569 DOI: 10.1016/j.rx.2011.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Revised: 05/23/2011] [Accepted: 05/23/2011] [Indexed: 12/29/2022]
Abstract
Acute pain in the right iliac fossa is common in children. It can arise from a wide variety of gastrointestinal and genitourinary processes that make up the differential diagnosis with acute appendicitis. In this article, we describe the most representative findings of these processes on ultrasonography. We emphasize the characteristics that enable these processes to be differentiated from acute appendicitis.
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Affiliation(s)
- L Raposo Rodríguez
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
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Koktener A, Yilmaz AE, Catal F, Eminoglu S. Doppler sonography of the superior mesenteric artery in children with recurrent abdominal pain. JOURNAL OF CLINICAL ULTRASOUND : JCU 2008; 36:341-345. [PMID: 18257106 DOI: 10.1002/jcu.20472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE Abdominal pain is one of the most common conditions in childhood and adolescence. The aim of this study was to evaluate the superior mesenteric artery (SMA) Doppler findings in children with recurrent abdominal pain. METHOD Duplex Doppler sonographic measurements were performed in 20 patients with recurrent abdominal pain and in 34 controls. RESULTS The mean blood flow velocities, blood flow volume, and diameter of the SMA were significantly lower in patients with recurrent abdominal pain than in controls. CONCLUSION Insufficient development and/or vasoconstriction of the SMA vascular bed may be involved in recurrent abdominal pain, but further studies on larger groups are needed to test this hypothesis.
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Affiliation(s)
- Asli Koktener
- Department of Radiology, School of Medicine, Fatih University, Alparslan Turkes Cad. No. 57, Ankara 06510, Turkey
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8
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Simanovsky N, Hiller N. Importance of sonographic detection of enlarged abdominal lymph nodes in children. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:581-4. [PMID: 17459999 DOI: 10.7863/jum.2007.26.5.581] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Abdominal lymph nodes are frequently visualized by sonography in the pediatric population. The term "mesenteric lymphadenitis" is frequently used in the radiologic literature to describe this finding, whereas in the pediatric literature, this term is reserved for specific inflammation of the lymph nodes. The purpose of this study was to compare by sonography the incidence of appearance of enlarged abdominal lymph nodes (EALNs) in healthy children compared with that in children with abdominal pain of various causes. METHODS In 200 patients referred for abdominal sonography for various indications, the presence of EALNs, their location, and size were registered. The patients were divided into 3 groups: those with abdominal pain due to an acute abdominal condition (group 1), those with abdominal pain without an acute abdominal condition (group 2), and asymptomatic patients (group 3). RESULTS Enlarged abdominal lymph nodes greater than 5 mm were detected in 83.3% of group 1 patients, 73.8% of group 2 patients, and 64% of group 3 patients. A significant statistical difference was found between patients with abdominal pain and asymptomatic children only for lymph nodes of 10 mm and larger (P = .0117). No statistically significant difference was seen in the presence of lymph node clusters between the patients with abdominal pain and asymptomatic children. There was a tendency of increased EALN occurrence with age, peaking at 10 years, with a decrease later. CONCLUSIONS Enlarged abdominal lymph nodes are frequently encountered in asymptomatic children and should not always be considered abnormal. Enlarged abdominal lymph nodes exceeding 10 mm in their shortest axis in children with abdominal pain may represent mesenteric lymphadenitis of various causes.
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Affiliation(s)
- Natalia Simanovsky
- Department of Radiology, Hadassah Medical Center, Hebrew University Medical School, Jerusalem, Israel.
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9
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Tawil MI. Pediatric Emergencies: Non-traumatic Abdominal Emergencies. Emerg Radiol 2007. [DOI: 10.1007/978-3-540-68908-9_32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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10
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Karmazyn B, Werner EA, Rejaie B, Applegate KE. Mesenteric lymph nodes in children: what is normal? Pediatr Radiol 2005; 35:774-7. [PMID: 15883829 DOI: 10.1007/s00247-005-1462-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2005] [Revised: 03/01/2005] [Accepted: 03/04/2005] [Indexed: 11/29/2022]
Abstract
BACKGROUND Enlarged mesenteric lymph nodes (MLN) are frequently seen in children with abdominal pain and, in the absence of other disorders, have been attributed to primary mesenteric lymphadenitis. OBJECTIVE To evaluate the prevalence of enlarged MLN (short axis>or=5 mm) as detected by abdominal CT in children with a low likelihood for mesenteric lymphadenopathy. MATERIALS AND METHODS During a 14-month period, we identified all non-contrast abdominal CT examinations performed at a tertiary care pediatric hospital for evaluation of suspected or known renal stones. Two radiologists reviewed the examinations and recognized all enlarged MLN, measured the short-axis diameter, and noted the quadrant location. RESULTS Sixty-one children were identified who met entry criteria; mean age was 10.7 years (range 1.1-17.3 years). Enlarged MLN were found in 33 (54%) of the 61 children; the largest enlarged MLN was most frequently in the right lower quadrant (RLQ) (29 of 33, 88%). Seventeen of the 61 children (28%) had three or more enlarged MLN; all were in the RLQ. The largest short-axis diameter measured was 10 mm. SUMMARY MLN with a short-axis diameter of >5-10 mm are commonly found on abdominal CT examination of children with a low likelihood for mesenteric lymphadenopathy and should be considered a non-specific finding. A short-axis diameter of 8 mm might better define the upper limit of normal mesenteric lymph node size in children.
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Affiliation(s)
- Boaz Karmazyn
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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11
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Rathaus V, Shapiro M, Grunebaum M, Zissin R. Enlarged mesenteric lymph nodes in asymptomatic children: the value of the finding in various imaging modalities. Br J Radiol 2005; 78:30-3. [PMID: 15673526 DOI: 10.1259/bjr/68274086] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The purpose of this study was to determine the prevalence of enlarged mesenteric lymph nodes in asymptomatic children. We prospectively studied 189 consecutive asymptomatic children from the outpatients' nephrological clinics who were referred for abdominal ultrasound. For comparison, we retrospectively reviewed the abdominal CT studies of 99 children, performed following blunt abdominal trauma. The children of both groups were divided into four subgroups according to their ages. The size, the number and the morphology of mesenteric lymph nodes were assessed. On abdominal ultrasound, enlarged mesenteric lymph nodes were detected in 55 of 189 asymptomatic children (29.1%). The longitudinal diameter of the lymph nodes ranged between 5 mm and 19 mm. These lymph nodes were arranged in clusters (three to nine in number in a cluster). All the lymph nodes were oval-shaped, flattened, and without any discomfort following graded transducer compression. On abdominal CT, enlarged mesenteric lymph nodes were diagnosed in 28 of the 99 children (28.3%). These lymph nodes measured more than 5 mm and were arranged in clusters (three or more in number). In seven of these children associated minimal mural thickening of the terminal ileum was seen. The presence of enlarged mesenteric lymph nodes in asymptomatic children of all ages and in both sexes is a common, non-specific finding and should be evaluated only in the appropriated clinical context.
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Affiliation(s)
- V Rathaus
- Department of Diagnostic Imaging, Sapir Medical Center affiliated to Sackler Medical School, Tel-Aviv University, Tel-Aviv, Israel
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12
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Schmidt MH, Sung L, Shuckett BM. Hemophagocytic lymphohistiocytosis in children: abdominal US findings within 1 week of presentation. Radiology 2004; 230:685-9. [PMID: 14990835 DOI: 10.1148/radiol.2303030223] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the ultrasonographic (US) findings at presentation in a series of children who received a diagnosis of hemophagocytic lymphohistiocytosis (HLH) at a single institution. MATERIALS AND METHODS All available results of imaging studies of children who received a diagnosis of HLH between January 1985 and June 2000 were retrieved. For nine patients, abdominal US images obtained within 1 week of presentation to the hospital were reviewed retrospectively by two radiologists who were aware of the diagnosis and of the original interpretation of each study. US images were examined for evidence of splenomegaly, hepatomegaly, ascites, gallbladder wall thickening, increased periportal echogenicity, lymphadenopathy, pleural effusion, and nephromegaly. Any other abnormalities were also recorded. Differences in interpretation were resolved by consensus. The patients ranged in age from 2 months to 4(1/2) years. The male-to-female ratio was 5:4. RESULTS Findings at presentation included splenomegaly (in eight of the nine children), hepatomegaly (in seven children), ascites (in six children), gallbladder wall thickening (in six children), increased periportal echogenicity (in three children), lymphadenopathy (in three children), and pleural effusion (in two children). Miscellaneous findings in individual patients included coarse hepatic echotexture with a single 9-mm hypoechoic focus in the liver, multiple hypoechoic foci in the spleen, nephromegaly, gallstone, increased renal cortical echogenicity, and mural thickening of the duodenum. CONCLUSION In the appropriate clinical setting, the differential diagnosis of a combination of hepatosplenomegaly, ascites, gallbladder wall thickening, increased periportal echogenicity, lymphadenopathy, and/or pleural effusion should include HLH.
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Affiliation(s)
- Matthias H Schmidt
- Department of Diagnostic Radiology, Dalhousie University, IWK Health Centre, 5850/5980 University Ave, Halifax, NS, Canada B3J 3G9.
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Vayner N, Coret A, Polliack G, Weiss B, Hertz M. Mesenteric lymphadenopathy in children examined by US for chronic and/or recurrent abdominal pain. Pediatr Radiol 2003; 33:864-7. [PMID: 13679999 DOI: 10.1007/s00247-003-0985-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2002] [Revised: 05/19/2003] [Accepted: 05/19/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND Children with recurrent abdominal pain often undergo US to confirm or exclude organic disease. OBJECTIVE To assess the prevalence of mesenteric lymphadenopathy on US in these children. MATERIALS AND METHODS We prospectively studied 189 children with recurrent abdominal pain with US of the abdomen, using graded compression. The results were compared with 73 children in a control group. The children in both groups were divided into three age groups. The size, number, morphology and location of mesenteric lymph nodes were noted, as well as additional findings. Pediatricians followed the patients from 3 months to 1 year, and a repeat US study was done in 30 children. RESULTS Mesenteric lymphadenopathy was present in 116 of 189 children (61.4%), with the greatest prevalence in boys in the younger age groups. The location of the nodes was mainly in the right lower quadrant. In the control group, 7 of 73 children had mesenteric lymphadenopathy, a significantly lower prevalence than in the study group ( P<0.001). Additional findings, apart from lymphadenopathy, were present in 27 (14.2%) of the 189 children in the study group, and in 5 (6.8%) of the 73 children in the control group. CONCLUSION Mesenteric lymphadenopathy is a common, and often the only abnormal, finding on US in children with recurrent abdominal pain.
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Affiliation(s)
- Natalie Vayner
- Institute of Imaging, Maccabi Health Care Services, Mered street 27, Tel Aviv, Israel
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Moustaki M, Zeis PM, Katsikari M, Fretzayas A, Grafakou O, Stabouli S, Tsolia M, Nicolaidou P, Karpathios T. Mesenteric lymphadenopathy as a cause of abdominal pain in children with lobar or segmental pneumonia. Pediatr Pulmonol 2003; 35:269-73. [PMID: 12629623 DOI: 10.1002/ppul.10254] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We investigated whether mesenteric lymphadenopathy could be a cause of abdominal pain in children with lobar or segmental pneumonia. The study population consisted of 1)119 consecutive children with lobar pneumonia, older than 4 years of age, and 2) 31 healthy controls. Demographic, clinical, inflammatory, and radiographic data were recorded in all patients. All study subjects underwent abdominal ultrasound, focusing on the identification of mesenteric lymphadenopathy. One month later, a follow-up ultrasound was performed in patients with enlarged mesenteric lymph nodes at the initial examination. Forty patients complaining of abdominal pain were included in group 1, while the remaining 79 were in group 2. The two groups of patients did not significantly differ regarding their demographic, clinical (other than abdominal pain), and radiographic indices. In contrast, enlarged mesenteric lymph nodes with a sagittal diameter of at least 10 mm were identified significantly more commonly in the children of group 1 (P = 0.001). The association of enlarged lymph nodes with the presence of abdominal pain remained significant when the data were analyzed through multiple regression analysis (odds raio, 1.47; 95% confidence interval, 3-44). Enlarged mesenteric lymph nodes were found in a significantly lower ratio of healthy controls (3/31) compared to that observed in group 1 (P = 0.003). In all patients who were followed up, mesenteric lymph nodes had either decreased or were not detectable. Our findings indicate that mesenteric lymphadenopathy might be considered as a mechanism responsible for the development of abdominal pain in a relatively high percentage of children with pneumonia.
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Affiliation(s)
- Maria Moustaki
- Second Department of Pediatrics, University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens, Greece
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Babcock DS. Sonography of the acute abdomen in the pediatric patient. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2002; 21:887-901. [PMID: 12164574 DOI: 10.7863/jum.2002.21.8.887] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To review the causes and sonographic appearance of pathologic processes that result in abdominal pain in the pediatric patient and to understand the use and limitations of abdominal sonography in the acute pediatric abdomen. METHODS A pictorial review of cases is presented. RESULTS Sonography in conjunction with color and pulsed Doppler imaging is a valuable tool in the evaluation of the acute abdomen in the pediatric patient. This article reviews the use of sonography in the evaluation of the acute abdomen in the pediatric patient. CONCLUSIONS The causes of the acute abdomen in children vary depending on the ages of the children. Sonography is a noninvasive modality and is useful for assessing these patients.
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Affiliation(s)
- Diane S Babcock
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Ohio 45229-3039, USA
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Koumanidou C, Vakaki M, Pitsoulakis G, Kakavakis K, Mirilas P. Sonographic detection of lymph nodes in the intussusception of infants and young children: clinical evaluation and hydrostatic reduction. AJR Am J Roentgenol 2002; 178:445-50. [PMID: 11804916 DOI: 10.2214/ajr.178.2.1780445] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Our aim was to assess the sonographic appearance of enlarged lymph nodes in the intussusception in infants and young children and to investigate whether the enlarged lymph nodes affect the hydrostatic reduction rate of intussusception. MATERIALS AND METHODS This retrospective case control study included a total of 65 children with intussusception, consisting of two groups: a study group of 28 patients with lymph nodes detected in intussusception and a reference group of 37 patients of similar age without lymph nodes in intussusception. The selection criterion for the study group was the presence of a minimum of two lymph nodes, of which at least one had a long axis of 11 mm or greater. The intussusception patterns, target or doughnut-like, and the presence of trapped fluid in the intussusception were also evaluated. Clinical records were reviewed for associated disease. The reducibility of both study and reference groups was assessed and correlated with all the sonographic features mentioned. RESULTS Twenty-two of the 28 patients in the study group and none in the reference group had a recent or a current history of gastroenteritis. The overall hydrostatic reduction rate was 46.4% in patients with enlarged lymph nodes in the intussusception and 81.1% (p < 0.005) in patients without enlarged lymph nodes in the intussusception. Larger rather than numerous lymph nodes significantly affected the reducibility rate. Most of the reference group patients had a hydrostatic reduction at first attempt, whereas a second attempt at hydrostatic reduction was required in most of the study group patients. CONCLUSION Enlarged lymph nodes in the intussusception are mainly found in patients with a current or recent history of gastroenteritis and decrease the overall hydrostatic reduction rate.
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Affiliation(s)
- C Koumanidou
- Department of Radiology, Agia Sofia Children's Hospital, Thivon and Mikras Asias Sts., Goudi, 11527 Athens, Greece
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Mesenteric adenitis-acute ileitis: A constellation of findings definable with ultrasound. Emerg Radiol 1998. [DOI: 10.1007/bf02749155] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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