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Chapter 9
215
The paediatric abdomen
CHAPTER CONTENTS
Hepatobiliary pathology 216
Pancreas 220
Normal appearances 220
Pathology of the pancreas 220
Urinary tract 221
Normal appearances 221
Anatomical variants and pathology 221
Adrenal glands 232
Normal appearances 232
Gastrointestinal tract 232
Ultrasound of the paediatric abdomen requires
different techniques and skills from those used in
the adult. Although there are a few situations in
which knowledge of adult pathology can be
applied to the paediatric patient, the child cannot
simply be considered a mini-version of an adult.
The presenting symptoms and pathological
processes in the child are generally quite different
from those in adults and the operator must be
fully aware of the special considerations of the paediatric
patient in terms of both diagnosis and technique.
This chapter addresses only the most
common paediatric situations likely to be encountered
in a general department, and further specialist
paediatric reading is recommended. (See the
general reading list at the end of this chapter.)
Techniques
The operator can minimize any distress to the
child, and make the examination considerably easier
and quicker, in numerous ways.
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The ultrasound environment should be as
friendly as possible, with appropriate decorations
and toys, and should always be kept warm
(nothing is more likely to make your patient
uncooperative than cold gel). Minimize the time
the child spends in the scanning room by having
everything ready first. Small children may
benefit from seeing a video of a scan beforehand
and being reassured that it will not hurt.
Most children find it reassuring to be accompanied
by their carer during the examination.