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Virtual Pediatric Hospital: Paediapaedia: Abdominal Ultrasound for Abdominal Pain Paediapaedia: Gastrointestinal Procedure Descriptions

Abdominal Ultrasound for Abdominal Pain

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Patient Preparation:
None

Contrast:
None

Technique:
Transducers
5 MHz linear in the neonate abdomen
3 + 5 MHz curved in the infant abdomen

Views to Take:
Transverse
1. Hepatic veins going into the inferior vena cava
2. Left lobe of the liver and left portal vein
3. Right lobe of the liver and right portal vein
4. Right lobe of the liver and gall bladder
5. Pancreas - document position of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV). The SMV should be anterior and to the right of the SMA. If it is not in the correction position, you should do an UGI to rule out malrotation.

Longitudinal
1. Left lobe of liver
2. Aorta/celiac axis/SMA - view may be obtained by scanning coronal from left side and angling slightly anterior. Measure the distance between the anterior wall of the aorta and the posterior wall of the liver. If the distance is greater than 1.7 times the diameter of the aorta the distance is abnormally increased and this can be due to lymphadenopathy, varices, or fat if the patient is on steroids.
3. IVC
4. Right lobe of liver and right kidney. As a rule of thumb, the liver edge should not extend below the edge of the kidney.
5. Spleen and measure it. As a rule of thumb, the spleen edge should not extend below the edge of the kidney.

Prone
Kidneys transverse and longitudinal - measure them
Adrenals

Pelvis in female
Transverse and longitudinal, check uterus and ovaries and for free fluid

References:
See References Chapter.

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