Diagnostic accuracy of point-of-care ultrasound for catheter-related thrombosis in children.

Background: Compared with consultative US performed by the radiology department, point-of-care US performed by non-radiology physicians can accurately diagnose deep venous thrombosis in adults.

Objective: In preparation for a multicenter randomized controlled trial, we determined the accuracy of point-of-care US in diagnosing central venous catheter-related thrombosis in critically ill children.

Materials And Methods: Children <18 years old with a central venous catheter who were admitted to the intensive care unit were enrolled.

Ultrasound-guided thoracoscopic dental extraction.

Recurrent pneumonias in children may be from an unrecognized aspirated foreign body. Our patient was a 10-year-old neurologically impaired child with an aspirated tooth in the right lower lobe segmental bronchus that was inaccessible to extraction using flexible bronchoscopy because of its extremely distal location. We used intraoperative ultrasound during thoracoscopy to locate the foreign body, a tooth, and to facilitate a wedge resection of the involved lung.

Gas-distended stomach masquerading as free air.

Free air can be an ominous sign of bowel perforation with the fear if resulting sepsis. Several radiological signs have been described to aid in interpretation including Rigler's sign. We present a case where a large amount of free air was felt to be present in a 5 year old post craniopharyngioma resection.

Correlation of complex ascites with intestinal gangrene and perforation in neonates with necrotizing enterocolitis.

Background/purpose: The purpose of this study was to determine whether a correlation exists between the finding of complex ascites on ultrasound (US) and the presence of intestinal perforation or gangrene in neonates with complicated necrotizing enterocolitis (NEC).

Methods: Charts of neonates with NEC (n = 76) whose care involved consultations with the pediatric surgery service between 2005 and 2008 were reviewed. Twenty-three babies with NEC without free air had a bedside abdominal US.

Ultrasound of ovarian sex-cord tumor with annular tubules.

Sex-cord tumors with annular tubules (SCTAT) have been extensively reported in the literature with great emphasis on the cytologic and histologic appearance. The association of Peutz-Jeghers syndrome (PJS) with bilateral benign, typically multifocal, small, and sometimes calcified SCTAT has also been reported. We present and describe the sonographic findings of bilateral SCTAT in a patient with PJS.

Multimodality imaging of an appendiceal intussusception.

Appendiceal intussusception is a rare entity. The majority of cases reported in the literature address surgical and colonoscopic approaches to treatment of the condition. The existing radiologic literature largely describes the sonographic and double-contrast enema findings of appendiceal intussusception.

MRI findings of rhabdomyolysis from streptococcal pharyngitis.

Rhabdomyolysis has been described as a rare sequela of severe infections by group A streptococcus related to toxic shock syndrome in adults. Streptococcal pharyngitis, on the other hand, has never been reported to cause rhabdomyolysis. We report a case of rhabdomyolysis in a child after an uncomplicated course of group A streptococcal pharyngitis.

Diagnostic imaging in the follow-up of nonoperative management of splenic trauma in children.

The spleen is the most frequently injured organ in blunt abdominal trauma (BAT). Contrast-enhanced computed tomography (CT) is approximately 95% sensitive and specific for detection of splenic injury. In children, nonoperative treatment is well-established.

Gastric thumbprinting: diffuse gastric wall mucosal and submucosal thickening in infants with ductal-dependent cyanotic congenital heart disease maintained on long-term prostaglandin therapy.

Seven infants with ductal dependent cyanotic congenital heart disease are reported. All were on prostaglandin E1 therapy to maintain ductus patency. All showed chest radiographic evidence of multiple masses indenting the stomach lumen (gastric thumbprinting).