Hendi Aditi,  Harty Mary,  Grissom Leslie

Final Pr. ID: Poster #: SCI-061

Colonic volvulus in the pediatric population is very rare with 40% mortality making timely diagnosis imperative. Radiologists should operate with a high degree of clinical suspicion in patients with risk factors for large bowel volvulus. Recognition of colonic volvulus on plain film, contrast enema and CT is paramount to work-up and definitive management. This case series is the largest from any single institution and describes the clinical course and imaging findings in cases of volvulus, with the goal of familiarizing the radiologist with the appearance of this disease entity on several imaging modalities. Read More

Authors:  Hendi Aditi , Harty Mary , Grissom Leslie

Keywords:  Colonic Volvulus, Pediatric, Large Bowel Volvulus, Colonic Obstruction, Acute Abdomen

Dewan Sannidhi

Final Pr. ID: Poster #: EDU-044

To illustrate the range of non-neuro pediatric emergencies evaluated by MRI, including abdominal, pelvic, and thoracic pathologies. To highlight technical and logistical considerations unique to emergency pediatric MRI. To review key diagnostic pearls and pitfalls through representative case examples.

Emergency MRI in pediatric patients is increasingly utilized as a radiation-free alternative when ultrasound or CT findings are equivocal. While neuroemergencies dominate MRI use, body MRI plays a critical role in evaluating acute conditions such as appendicitis, cholecystitis, pancreatitis, ovarian torsion and pancreatic trauma.
This exhibit presents a curated series of de-identified emergency body MRI cases, emphasizing characteristic imaging features, differential considerations, and clinical relevance. Each case demonstrates how MRI provides superior soft-tissue contrast, precise localization, and improved diagnostic confidence in urgent scenarios.
The poster also addresses practical challenges in performing emergency MRIs in children—scanner availability, need for sedation, patient motion, and interdepartmental coordination. Strategies to overcome these challenges are discussed, including abbreviated MRI protocols, feed-and-sleep methods, and child-life support to reduce sedation dependence.
Illustrative examples highlight both successful and technically challenging studies, reinforcing key teaching points such as motion artifact mitigation and protocol selection for specific clinical questions. Read More

Authors:  Dewan Sannidhi

Keywords:  MRI, Abdomen MRI, Emergencies

Ferrer Valencia Valentina,  Chow Jeanne,  Zhang Da,  Callahan Michael,  Kephart Morie,  Tsai Andy

Final Pr. ID: Poster #: SCI-025

Nephrolithiasis, once considered an adult condition, is now increasingly prevalent in pediatric populations, leading to flank pain, hydronephrosis, and potential renal failure. Traditional imaging modalities for diagnosing pediatric nephrolithiasis, such as ultrasound and CT, are evolving, with newer protocols (e.g., ultra-low dose CT with tin filtration) being developed. The aim of this study was to design and validate an ex vivo porcine model to simulate pediatric renal stones, providing a substrate for the advancement of imaging techniques in renal stone detection and characterization. Read More

Authors:  Ferrer Valencia Valentina , Chow Jeanne , Zhang Da , Callahan Michael , Kephart Morie , Tsai Andy

Keywords:  Abdomen CT, Renal Stones, Ultrasound

Buyukkaya Ayla,  Zawin Joan

Final Pr. ID: Poster #: CR-015

Menetrier’s Disease is a rare form of hypertrophic gastropathy characterized by excessive mucous secretion, protein loss, and enlarged gastric folds. It poses a diagnostic challenge due to its nonspecific clinical presentation and is often misdiagnosed as more common gastric disorders. Although more prevalent in adults, pediatric cases—frequently associated with cytomegalovirus (CMV) infection—can present acutely and typically resolve spontaneously. We present a case that underscores the importance of recognizing this rare condition in children to ensure timely diagnosis and appropriate management.
A previously healthy 3-year-old boy presented with vomiting, anorexia, wet cough, and prominent periorbital and peripheral edema. Laboratory tests revealed hypoproteinemia, hypoalbuminemia, and elevated stool α1-antitrypsin levels, suggestive of protein-losing enteropathy. CMV viremia was detected, with no leukocytosis or peripheral eosinophilia.
Imaging studies, including abdominal ultrasound and computed tomography, revealed thickened and hyperemic gastric walls, moderate abdominopelvic ascites, and pleural effusion. CT demonstrated markedly enlarged and tortuous gastric folds in the fundus and body, particularly along the greater curvature, with sparing of the antrum and preserved gastric wall thickness between folds. The presence of tiny cystic structures within the thickened folds, likely representing hypertrophied glands, helped differentiate the condition from solid gastric tumors.
The differential diagnosis included eosinophilic gastritis, infectious gastritis (e.g., Helicobacter pylori), Crohn’s disease, Zollinger-Ellison syndrome, gastric lymphoma, gastrointestinal stromal tumors (GISTs), and familial protein-losing enteropathy. Upper gastrointestinal endoscopy confirmed the presence of enlarged polypoid folds in the fundus and body with mucosal hyperemia—findings consistent with Menetrier’s Disease.
This case highlights a classic presentation of pediatric Menetrier’s Disease associated with CMV infection. Recognition of its characteristic features and self-limiting nature in children is crucial to avoid unnecessary diagnostic procedures and interventions. Supportive care remains the cornerstone of treatment. Read More

Authors:  Buyukkaya Ayla , Zawin Joan

Keywords:  Stomach, Abdomen CT, Ultrasound

Devkota Shritik,  Lampl Brooke,  Park Ellen

Final Pr. ID: Poster #: EDU-051

Ultrasound (US) is commonly the first-line imaging modality in pediatric body imaging due to its safety, portability, and lack of radiation. However, US is dependent on the variable skills of sonographers amplified by increased remote interpretation. US images can be misinterpreted without a clear understanding of anatomy and critical features for a diagnosis.

This educational exhibit aims to raise awareness of misdiagnosed entities in pediatric US and provide practical strategies to avoid common pitfalls. Each case will be presented with representative images and clinical context, followed by a discussion of how the initial misdiagnosis was identified and corrected.

We will present several illustrative cases, including (not limited to):
1. Mistaking the gastroesophageal junction for the pylorus due to incorrect scanning position. Proper landmarks and techniques will be reviewed to avoid this pitfall.
2. Ruptured appendicitis with inflammatory mass wrongly diagnosed as ileocolic intussusception. Review of classic features of ileocolic intussusception and possible differentials to avoid this pitfall.
3. Painful groin swelling in an infant female interpreted as a necrotic lymph node by the sonographer. Further evaluation revealed a canal of Nuck hernia with herniated ovary and vascular pedicle. Cine clips and doppler evaluation must be reviewed. The entire structure must be traced to avoid misdiagnosis.
4. Terminal ileum was falsely identified as a blind-ending appendix in a suspected appendicitis case. Review of anatomy and ultrasound features of the appendix versus terminal ileum.
5. Thickened ileocecal valve mistaken for an ileocolic intussusception. US features of normal ileocecal valve versus ileocolic intussusception will be reviewed.

This educational exhibit reminds us of the difficulties of pediatric ultrasound and its dependence on the sonographer. We aim to equip radiologists with practical insights to avoid pitfalls in diagnosis. These examples highlight the challenges that may be encountered in US and emphasize the importance of a methodical approach, thorough technique, and recognition of diagnostic errors. Read More

Authors:  Devkota Shritik , Lampl Brooke , Park Ellen

Keywords:  Ultrasound, Abdomen

Kosaraju Sriya,  Errampalli Eric,  Illimoottil Mathew,  Priya Lakshmi,  Orscheln Emily

Final Pr. ID: Poster #: EDU-046

Appendicitis is an important cause of abdominal pain and is the leading reason for emergent surgery in children. Prompt and accurate diagnosis is important because delayed diagnosis increases the risk of rupture and false positive diagnosis may result in unnecessary surgery. While it can occur at any age, it most frequently occurs in pediatric patients. Further, the rate of perforation is higher in younger children. However, the differential diagnosis for pediatric abdominal pain is broad and includes many non-surgical diagnoses. Localization of pain can also be more difficult in children, posing an additional challenge. In this educational exhibit, we will discuss some clinical mimics of appendicitis and characteristic imaging findings to help differentiate them. Topics covered include omental infarct, typically a self-limited condition, but a cause of abdominal pain that has been identified in 0.024 to 0.1% of cases of surgery for appendicitis. In the rare cases that do require surgery, the surgical approach differs from that for appendicitis. In addition, we will discuss epiploic appendagitis, yet another self limiting condition in which proper diagnosis prevents unnecessary surgery. We will discuss Meckel’s diverticulum, which when inflamed may mimic acute appendicitis very closely in imaging appearance as well as clinical presentation. However, these entities can be differentiated if the inflamed structure can be identified as arising from the ileum rather than the cecum. Finally, we will also discuss other clinical appendicitis mimics such as mesenteric adenitis, inflammatory bowel disease, ileocolic intussusception, and ovarian torsion, and we will contrast the imaging appearance of lymphoid hyperplasia of the appendix with acute appendicitis. Read More

Authors:  Kosaraju Sriya , Errampalli Eric , Illimoottil Mathew , Priya Lakshmi , Orscheln Emily

Keywords:  appendicitis, omental infarct, abdomen

Baheti Akshay,  Rajasimman Aishvarya Shri,  Patil Vasundhara,  Gala Kunal,  Shetty Nitin,  Kulkarni Suyash,  Ramadwar Mukta,  Panjawani Poonam,  Qureshi Sajid

Final Pr. ID: Poster #: SCI-030

Pediatric hepatic neoplasms include a variety of differentials which vary with the child’s age. We evaluated the diagnostic accuracy of certain imaging features on CECT in differentiating these tumors, particularly for identifying hepatoblastoma. Read More

Authors:  Baheti Akshay , Rajasimman Aishvarya Shri , Patil Vasundhara , Gala Kunal , Shetty Nitin , Kulkarni Suyash , Ramadwar Mukta , Panjawani Poonam , Qureshi Sajid

Keywords:  Abdomen CT, Liver Tumor, Heptoblastoma

Gnesda Ryan,  Lewis Heidi,  Kucera Jennifer

Final Pr. ID: Poster #: EDU-091

Intraperitoneal focal fat infarction is an umbrella term used to describe numerous pathologies with the two most common encountered in clinical practice being epiploic appendagitis and omental infarction. The clinical presentation often mimics an acute abdomen, which can lead to inappropriate management of the patient. While there is ample literature regarding the imaging appearance of focal fat infarction in adults, little exists regarding the imaging findings in children. The purpose of this exhibit is to demonstrate the imaging features which will allow radiologists to confidently diagnose focal fat infarction and differentiate it from more emergent causes of an acute abdomen. We will also discuss the prognosis and appropriate management, usually conservative, which is a significant difference from other causes of an acute abdomen. Read More

Authors:  Gnesda Ryan , Lewis Heidi , Kucera Jennifer

Keywords:  Acute Abdomen, Epiploic Appendagitis, Omental Infarct

Aamir Asmaa,  Bailey Smita

Final Pr. ID: Poster #: CR-007

Protein- losing enteropathy (PLE) is a serious complication that can occur after the Fontan operation. Increased systemic venous pressure can cause altered mesenteric circulation, lymphangiectasis, and enteric protein loss. PLE can cause significant morbidity with hypoalbuminemia, coagulation abnormalities and hypogammaglobulinemia. Dynamic contrast- enhanced (DCE) MR lymphangiography (MRL) is a minimally invasive technique that has emerged as a valuable tool for imaging lymphatic flow and lymphatic disorders. DCE MRL can aid in the localization of lymphatic leak in the intestinal lumen. The purpose of this presentation is to review the technique of DCE MRL for evaluation of protein- losing enteropathy along with the imaging findings.
We present a 12 year old female with congenital heart disease including single ventricle, heterotaxy with dextrocardia. She had a bilateral bidirectional Glenn procedure complicated by prolonged chylous effusion requiring thoracic duct ligation and pleurodesis. She underwent non-fenestrated extracardiac Fontan which was complicated by protein-losing enteropathy. Lymphatic embolization was done however she developed recurrent PLE. DCE MRL demonstrated leakage of contrast in the duodenum and proximal jejunum. She underwent thoracic duct decompression procedure which resulted in significantly improved symptoms. Read More

Authors:  Aamir Asmaa , Bailey Smita

Keywords:  MRI Lymphangiography, Abdomen

Dawoud Malik,  Buchmann Robert

Final Pr. ID: Poster #: CR-004

We report a case of systemic juvenile xanthogranuloma affecting the liver in an 18 month old male. Read More

Authors:  Dawoud Malik , Buchmann Robert

Keywords:  Abdomen, Histiocytosis

Seekins Jayne,  Newman Beverly

Final Pr. ID: Poster #: EDU-034

Causes of paucity of bowel gas in the neonate abdomen can vary widely. This case series will review common and uncommon causes of paucity of bowel gas on abdominal radiography in the newborn as well as further imaging strategies to achieve a rapid diagnosis. Entities range from solid organ enlargement and masses as well as diseases of bowel origin. Evaluation of the most common causes of the lack of bowel gas with x-ray, ultrasound and fluoroscopy can lead to rapid diagnosis and treatment, especially if not prenatally diagnosed. This series will also discuss the utility of post-natal CT and/or MRI in select cases. Read More

Authors:  Seekins Jayne , Newman Beverly

Keywords:  Paucity of bowel gas, Neonate, Abdomen

Misiura Anne,  Urbine Jacqueline,  Poletto Erica,  Malik Archana,  Mallon Mea

Final Pr. ID: Poster #: EDU-032

The spleen is rarely the first organ to come to mind in discussing pathology of the abdomen, and indeed may often be the last. However, there are a multitude of splenic processes and abnormalities that should be kept in mind when discussing the pediatric abdomen. Additionally, splenic abnormalities, or lack thereof, can also be clues to diagnosis in more difficult cases. Read More

Authors:  Misiura Anne , Urbine Jacqueline , Poletto Erica , Malik Archana , Mallon Mea

Keywords:  Spleen, gastrointestinal, abdomen

Herzog Abigal,  Cuevas Christian,  Mao Lu,  Tutman Jeffrey,  Squires Judy,  Chapman Teresa

Final Pr. ID: Poster #: SCI-022

It is well-established and widely observed that newborn infants imaged by ultrasound may show transiently increased echogenicity of the renal pyramids within the first week of life, up to 10 days, postulated to reflect reduced excretion of urine that has been observed early in life. Over the past decade, as ultrasound technology has improved, we have observed in routine practice that many infants without renal disease manifest this echogenicity for several weeks and sometimes over a month. The aim of this study is to establish a new expected age range during which healthy infants may show hyperechogenicity of the renal pyramids using modern ultrasound equipment. Read More

Authors:  Herzog Abigal , Cuevas Christian , Mao Lu , Tutman Jeffrey , Squires Judy , Chapman Teresa

Keywords:  Abdomen, Renal, Neonatal