Pediatric abdomen

A free gallery of high-resolution, ultrasound, color doppler and 3D images

Ultrasound images of pediatric abdomen:

Ectopic kidney or Renal ectopia:

1) Pelvic kidney in neonate:

This female neonate presented with imperforate anus. Sonography reveals normally located right kidney. However the left kidney is not visualized in left renal fossa. Ultrasound images reveal a pelvic kidney that appears somewhat rounded, located posterior and superior to the bladder. The renal pyramids of both kidneys appear echogenic suggestive of early nephrocalcinosis. The uterus of this neonate was not visualized well. Color doppler imaging shows the vascularity of the pelvic kidney. Images taken using a Toshiba Xario machine.

Reference: http://www.thefetus.net/page.php?id=549 (a good article on pelvic kidney, with free images).

2) Nephrocalcinosis in neonates:

These ultrasound images of neonatal kidneys show- markedly echogenic renal pyramids, bilaterally, with chief involvement of the tips suggestive of medullary nephrocalcinosis. Such nephrocalcinosis in neonates usually follows long term parenteral therapy or due to use of certain drugs notably gentamicin and furosemide. It can also be caused by low fluid intake in the neonate and due to oxygen dependency. This condition, in neonates, usually resolves following correction of the etiological factors. Case courtesy of Joe Antony, MD, India. Images taken using a Toshiba Xario machine.

Also see: http://www.ultrasound-images.com/renal-calculi.htm (where I describe nephrocalcinosis in adults).

3) Communicating hydrocele in neonate:

This neonate showed a swelling of the Rt. scrotum. Sonography of the pelvis and scrotum revealed a right sided hydrocele (seen as a hypoechoic collection surrounding the right testes). The hydrocele also appears to communicate (arrows) with the abdomen through a patent processus vaginalis. This patent communication may cause a hernia or hydrocele to persist in infants. These ultrasound images are diagnostic of communicating hydrocele.

Images courtesy of Dr. Ravi Kadasne, Radiologist, UAE, who used a Philips IU 22 ultrasound machine, here.

Reference: http://www.emedicine.com/ped/topic1037.htm (free article).

4) Bilateral communicating hydrocele in neonate:

The above ultrasound images show gross bilateral communicating hydrocele in a neonate, which was found to have Hydrops fetalis in utero. Note the presence of ascitic fluid with communication with the hydrocele (arrow in figure below).

5) Persistent vesico-urachal diverticulum in child:

This 4 yr. old male child had severe pain in the lower abdomen. Sonography revealed a tubular hypoechoic structure leading to the urinary bladder from just below the umbilicus. These ultrasound images suggest a diagnosis of inflammation of the persistent vesico-urachal diverticulum. The urachus is a duct that leads from the urinary bladder to the umbilicus in the fetus. Peristence of the urachal duct can present as a sinus or diverticulum in children. Ultrasound images taken using a Philips IU 22 machine by Dr. Ravi Kadasne. UAE.

Reference: 1) http://www.emedicine.com/ped/topic1402.htm (free article)

2) http://www.nlm.nih.gov/medlineplus/ency/article/002993.htm

6) Sonography of renal fungal balls in neonate:

The above ultrasound images (LEFT) shows 2 echogenic, rounded, non-shadowing mass lesions in the renal pelvis of right kidney. The left kidney of the neonate shows pelvicalyceal dilation with a few echogenic foci in the calyces. The neonate was undergoing prolonged antibiotic therapy following sepsis after preterm delivery.

Following are ultrasound images after 2 weeks:

The follow up ultrasound images of the same neonate after 2 weeks show presence of the more rounded masses in the right kidney which also shows mild dilation of the renal pelvis. Smaller lesions are seen in the left kidney with pelvicalyceal dilation. The right kidney also shows rounded lesions in the pelvi-ureteric junction region. The urinary bladder also shows small rounded lesions floating within it. Such lesions are usually due to fungal balls or blood clots. Since blood clots in the renal collecting system usually dissolve after a few days, these ultrasound images suggest fungal balls in the kidneys and urinary bladder. The dilated pelvi-calyces of both kidneys suggest obstruction produced by the fungal balls in the collecting system.

Reference: http://radiology.rsnajnls.org/cgi/reprint/142/2/473.pdf

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This page was last edited on: Thursday June 04, 2009 02:28 PM

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