Purpose or Case Report: Acute abdomen is one of the most common presentations encountered in any pediatric emergency department. This educational exhibit refreshes reader with the most common causes of acute abdomen encountered in the pediatric population through a simple mnemonic (AIM)² which includes Appendicitis, Adhesions, Intussusception, Incarcerated inguinal hernia, Meckel’s diverticulum and Mal-rotation with midgut volvulus. Initial abdominal radiographs and confirmatory ultrasound and/or cross-sectional images including CT and MRI will be presented.
There will be emphasis on “Image Gently” principles in keeping with minimum radiation exposure to our most vulnerable pediatric population. The best use of available diagnostic modality with the least or no radiation is suggested for given pathologies and clinical scenarios in pediatric patients. Also, appropriateness criteria for the diagnostic studies will be reviewed in our exhibit.
Plain films may reveal an abnormal bowel gas pattern, which may suggest an underlying pathology. Use of ultrasound as part of the initial evaluation is advocated in many situations because it may be quickly performed at bedside and repeated as needed without harmful ionizing radiation. In certain cases, ultrasound examination may be confirmatory.
CT is best used when the initial tests are unrevealing, or when the patient is acutely deteriorating. CT has proven to save lives of children by allowing prompt and accurate evaluation. Minimizing radiation exposure while maintaining diagnostic accuracy remains an ongoing effort of the entire care team, including the radiologists, radiology technologists and the referring physicians.
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