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Pancreatitis

KEY FACTS Terminology Acute pancreatitis (AP): Acute inflammation of pancreas with variable involvement of local tissues/remote organs 2 of 3 features required for diagnosis: Abdominal pain consistent with disease, 3x rise in serum amylase or lipase, or imaging findings consistent with AP 2 types of AP: Interstitial edematous vs. necrotizing Fluid collections – Pancreatic pseudocyst: Fluid collection associated with interstitial edematous pancreatitis after first 4 weeks…

Meckel Diverticulum

KEY FACTS Terminology Most common omphalomesenteric duct remnant Imaging Classic imaging appearance (in patient with GI bleeding): Focal persistent accumulation of radiotracer in right lower quadrant on nuclear pertechnetate scan (Meckel scan) Coincident with & isointense to gastric uptake as ∼ 65% of symptomatic Meckel diverticula contain ectopic gastric mucosa Other modalities (US, CT, MR) Blind-ending tubular structure may be inconspicuous May present as cyst, even…

Ileocolic Intussusception

KEY FACTS Terminology Invagination of distal small bowel (intussusceptum) into colon (intussuscipiens) in telescope-like manner Imaging US: Best diagnostic modality if clinically suspected Round mass with target sign in right abdomen Mean diameter of 2.6 cm (vs. 1.5 cm for purely small bowel intussusceptions) Sweeping transducer proximal & distal shows relationship to small & large intestine May see entrapped lymph nodes, appendix, other pathologic lead points…

Appendicitis

KEY FACTS Terminology Acute obstruction of appendiceal lumen → distention → ↑ intraluminal pressure → venous obstruction → ischemia → superimposed infection of appendiceal wall → eventual perforation Imaging US 1st-line modality in child with RLQ pain Noncompressible, dilated, tubular blind-ending structure (appendix) in RLQ with induration of surrounding fat – ± echogenic, shadowing appendicolith US diameter of appendix ≥ 6 mm (during compression) suggestive of…

Hernias

KEY FACTS Terminology Hernia: Protrusion of contents from normally encasing body cavity through normal or abnormal opening Inguinal hernia: Protrusion of abdominal contents through defect in inguinal region Indirect inguinal hernia: Contents protrude into open deep inguinal ring, extend through patent processus vaginalis, & exit superficial inguinal ring – 15% of inguinal hernias bilateral – In females, ovary may herniate through canal of Nuck Umbilical hernia:…

Ingested Multiple Magnets

KEY FACTS Terminology Ingestion of multiple magnets or single magnet + additional metallic foreign bodies Potential for significant bowel complications Rare-earth magnets 5-10x stronger than traditional magnets Imaging Metallic density foreign bodies; shapes variable Magnets attract through bowel walls Multiple “stacked” magnets may simulate single rectangular or cylindrical foreign body Entrapment of interposed bowel wall suggested with Gap between otherwise closely apposed magnets or magnet &…