Physical Address

304 North Cardinal St.
Dorchester Center, MA 02124

Congenital Diaphragmatic Hernia

KEY FACTS Terminology Herniation of abdominal contents into chest via congenital defect in diaphragm, most commonly posterior (Bochdalek) Side of congenital diaphragmatic hernia (CDH): Left 85%, right 13%, bilateral 2% Imaging Best clue: Bubbly, round, or tubular, relatively uniform air-filled lucencies in hemithorax displacing mediastinum Intrathoracic herniated contents may include stomach, small & large bowel, liver, gallbladder, spleen Results in paucity of bowel gas in abdomen…

Esophageal Atresia and Tracheoesophageal Fistula

KEY FACTS Terminology Atresia: Congenital occlusion of lumen Fistula: Anomalous connection between 2 lumens Imaging 5 major anatomic variations of esophageal atresia-tracheoesophageal fistula (EA-TEF) Fistula level variable depending on type of EA-TEF Most commonly above/near carina Atretic segments variable in length Gap often long in EA without TEF Radiographs Air-distended upper esophageal pouch Enteric tube tip near thoracic inlet in pouch EA with TEF: Gas in…

Approach to Pediatric Chest

Imaging Modalities Radiography Imaging investigation of most thoracic symptoms (whether suggestive of pulmonary, cardiovascular, gastrointestinal, or chest wall origin) almost always begins with chest radiographs. In patients who are clinically stable & capable of following directions, the preferred technique is upright frontal (PA) & lateral views of the chest with full inspiration. However, supine (AP) views will typically be employed in patients who are unstable or…

Croup

KEY FACTS Terminology Benign, self-limited viral inflammation of upper airway Symmetric subglottic edema results in stridor & characteristic “barky” cough Imaging Diagnosis usually clinical; radiographs used to exclude more serious causes of stridor Frontal view: Often more revealing than lateral view Gradual symmetric tapering of subglottic trachea from inferior to superior – “Steeple,” “pencil tip,” or “inverted V” configuration – Loss of normal “shoulders” (focal lateral…