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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2023; 33(02): 218-229
DOI: 10.1055/s-0042-1759481
Review Article

ICRI White Paper: An Update on Role of Conventional Radiography in Imaging of Pediatric Gastrointestinal Tract

Sanjay N. Jain
1   Department of Radiology, Prince Aly Khan Hospital, Aga Hall, Nesbit Road, Mazagaon, Maharashtra, India
,
Rushit S. Shah 
2   Department of Radiology, TNMC and BYL Nair Hospital, Mumbai Central, Mumbai, Maharashtra, India
,
Tanvi Modi 
2   Department of Radiology, TNMC and BYL Nair Hospital, Mumbai Central, Mumbai, Maharashtra, India
,
Ravi U. Varma
2   Department of Radiology, TNMC and BYL Nair Hospital, Mumbai Central, Mumbai, Maharashtra, India
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Abstract

Plain abdominal radiographs and gastrointestinal contrast studies remain the first line of investigation for the evaluation of several conditions due to their easy availability and ease of use in pediatric patients. A systematic approach to evaluating the plain radiograph for pediatric abdomen can lead the radiologist to a relevant differential diagnosis in most cases. In other cases, it leads the radiologist to the next line of investigation. The plain radiograph of the abdomen is requested for several conditions ranging from abdominal pain, vomiting, failure to pass meconium, abdominal distension, perforation, mass or for suspected obstruction. The radiation dose involved in abdominal radiography, although significant, the diagnostic information provided outweighs the risk. Dose reduction techniques should be employed to reduce the radiation dose to infants and children. Spectrum of atresias and stenosis from the esophagus up to the rectum, Hirschsprung disease, small left colon syndrome, and anorectal malformations can be identified with a detailed and systematic contrast study. They act as an adjunct in the diagnosis of conditions such as intussusception and hypertrophic pyloric stenosis. Inflammatory conditions such as acute appendicitis, necrotizing enterocolitis, and acute conditions such as pneumoperitoneum are also well appreciated on plain abdominal radiographs.

Keywords

plain radiograph - abdomen - pediatric - intestinal obstruction - pneumoperitoneum


Publication History

Article published online:
29 December 2022

© 2022. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Frush DP, Slovis TL. Radiation bioeffects, risks, and radiation protection in medical imaging in children. In: Coley BD. ed. Caffey's pediatric diagnostic imaging. 12th ed.. Philadelphia, PA: Elsevier/Saunders; 2013: 3-11
    Google Scholar
  • 2 Whitley AS, Clark KC. Clark's positioning in radiography. 12th ed.. London, New York, NY: Hodder Arnold; 2005: xiv , 398–401
    CrossrefGoogle Scholar
  • 3 IRefer Guidelines: Making the Best Use of Clinical Radiology. 8th ed.. The Royal College of Radiologists (RCR); 2017. Accessed October 21, 2022 at: www.irefer.org.uk
    Google Scholar
  • 4 Hiorns MP. Gastrointestinal tract imaging in children: current techniques. Pediatr Radiol 2011; 41 (01) 42-54
    CrossrefPubMedGoogle Scholar
  • 5 del-Pozo G, Albillos JC, Tejedor D. et al. Intussusception in children: current concepts in diagnosis and enema reduction. Radiographics 1999; 19 (02) 299-319
    CrossrefPubMedGoogle Scholar
  • 6 Applegate KE. Intussusception. In: Coley BD. ed. Caffey's pediatric diagnostic imaging. 12th ed.. Philadelphia, PA: Elsevier/Saunders; 2013: 1135-1143
    Google Scholar
  • 7 Hernanz-Schulman M. Hypertrophic pyloric stenosis. In: Coley BD. ed. Caffey's pediatric diagnostic imaging. 12th ed.. Philadelphia, PA: Elsevier/Saunders; 2013: 1039-1047
    Google Scholar
  • 8 Blickman JG, Parker BR. Gastrointestinal Tract. In: Blickman JG, Parker BR, Barnes PD. eds. Pediatric radiology: the requisites. 3rd ed.. Philadelphia, PA: Mosby/Elsevier; 2009. ; ix, 63–102
    Google Scholar
  • 9 Currarino G. The value of double-contrast examination of the stomach with pressure “spots” in the diagnosis of infantile hypertrophic pyloric stenosis. Radiology 1964; 83: 873-878
    CrossrefPubMedGoogle Scholar
  • 10 Hernanz-Schulman M. Congenital and neonatal disorders. In: Coley BD. ed. Caffey's pediatric diagnostic imaging. 12th ed.. Philadelphia, PA: Elsevier/Saunders; 2013: 1057-1080
    Google Scholar
  • 11 Vinocur DN, Lee EY, Eisenberg RL. Neonatal intestinal obstruction. Am J Roentgenol 2012; 198 (01) W1-10
    CrossrefPubMedGoogle Scholar
  • 12 Lin AN. Pyloric atresia and epidermolysis bullosa. Pediatr Dermatol 1997; 14 (05) 406-408
    CrossrefPubMedGoogle Scholar
  • 13 Javors BR, Bittane RM. Applied embryology of the gastrointestinal tract. In: Gore RM, Levine MS. eds. Textbook of gastrointestinal radiology. 4th ed.. Philadelphia, PA: Elsevier/Saunders; 2015: 2079-2094
    Google Scholar
  • 14 Feinstein KA, Fernbach SK. Neonatal gastrointestinal radiology. In: Gore RM, Levine MS. eds. Textbook of gastrointestinal radiology. 4th ed.. Philadelphia, PA: Elsevier/Saunders; 2015: 2095-2124
    Google Scholar
  • 15 Feinstein KA, Fernbach SK. Diseases of the pediatric colon. In: Gore RM, Levine MS. eds. Textbook of gastrointestinal radiology. 4th ed.. Philadelphia, PA: Elsevier/Saunders; 2015: 2164-2179
    Google Scholar
  • 16 Swischurk LE. Alimentary tract. In: Swischurk LE. ed. Imaging of the Newborn, Infant and Young Child. 5th ed.. Lippincott Williams and Wilkims; 2004: 341-482
    Google Scholar
  • 17 Dunn EA, Olsen ØE, Huisman TAGM. The pediatric gastrointestinal tract: what every radiologist needs to know. In: Hodler Jr, Kubik-Huch RA, Schulthess GKV. eds. Diseases of the Abdomen and Pelvis 2018–2021: diagnostic imaging - IDKD book. Cham, Switzerland: Springer; 2018. (viii):157–66
    Google Scholar
  • 18 Pruthi S, Singh SP, Hilmes MA. The abdominal wall and peritoneal cavity. In: Coley BD. ed. Caffey's pediatric diagnostic imaging. 12th ed.. Philadelphia, PA: Elsevier/Saunders; 2013: 1157-1180
    Google Scholar
  • 19 Messmer JM, Levine MS. Gas and soft tissue abnormalities. In: Gore RM, Levine MS. eds. Textbook of gastrointestinal radiology. 4th ed.. Philadelphia, PA: Elsevier/Saunders; 2015: 178-196
    Google Scholar
  • 20 Raturi S, Chandran S, James TE, Rajadurai VS. Radiological signs of pneumoperitoneum in an extremely low birthweight infant. BMJ Case Rep 2014; 2014: bcr2014205510
    CrossrefPubMedGoogle Scholar
  • 21 Chiu YH, Chen JD, Tiu CM. et al. Reappraisal of radiographic signs of pneumoperitoneum at emergency department. Am J Emerg Med 2009; 27 (03) 320-327
    CrossrefPubMedGoogle Scholar
  • 22 Xiang H, Han J, Ridley WE, Ridley LJ. Leaping dolphin sign: pneumoperitoneum. J Med Imaging Radiat Oncol 2018; 62 (Suppl. 01) 87-87
    CrossrefPubMedGoogle Scholar
  • 23 Rajkumar T. Flying bird sign or eagle sign in pneumoperitoneum. WJPMR 2017; 3 (04) 78-82
    Google Scholar