Abdominal ultrasound in children - are we careful enough when it comes to lung bases?

Abstract

Objective - To investigate the frequency of positive findings within the lung bases during abdominal ultrasound (US) examinations in children with referral diagnosis not suggesting pulmonary disease.

Materials and methods - A retrospective study included all children with abdominal US performed within 2 years by a single pediatric radiologist in the regional children's hospital. Of all examined children, 22 (mean 7.4 y, SD=4.2 y) had pathological findings detected within the lung bases, without referral diagnosis suggesting a pulmonary pathology. Each abdominal US included a trans-abdominal (trans-hepatic and trans-splenic) approach to both lung bases.

Results - While performing abdominal US a detected pulmonary pathology included: 19 pneumonias and 3 pleuropneumonias, with the most common referral diagnosis being abdominal pain (15 children), followed by nausea and vomitting (3 children), febrile convulsiones (2 children), exacerbation of juvenile arthritis (1), and a routine follow-up a day after hydrostatic reduction of ileocolic intussusception (1). In outpatients with referral diagnosis of abdominal pain, 0.95% had positive lung base US findings.

Conclusion - Each radiologist should be aware of the potential pathological finding within the lung bases when performing abdominal ultrasound in children. Its detection might have a serious impact on the patient's treatment.