PURPOSE: The correlation between sonographic findings and clinical symptoms was investigated in the patients with mesenteric lymphadenitis who had recurrent acute abdomen. MATERIALS AND METHODS: Seventy-eight children with recurrent acute abdominal pain without obvious primary disease were evaluated by sonography. The initial and follow-up sonography were performed in 17 children. The abdomen was divided into 3 areas. The number and size of mesenteric lymph nodes were observed in each zone, and was compared with the clinical findings. RESULTS: In 56(71.8%) of 78 cases, good correlation was seen in the area of the greatest size and number of the lymph nodes in the sonography. Most severe symptom, was seen in the right lumbar area(49 cases) and umbilical area(7 cases). In 17 cases of follow up, 14 cases showed decrease size and number of mesenteric lymph nodes while 2 cases showed increase in size and number of the nodes with aggravated symptoms. CONCLUSIONS: Ultrasonography was useful to detect and localize the enlarged mesenteric lymph nodes. Initial and follow-up sonography showed good correlation between the changes in number and size of the lymph nodes and symptoms.
Abdomen ; Abdomen, Acute* ; Abdominal Pain ; Child* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Mesenteric Lymphadenitis* ; Ultrasonography*

With recent technical advances, increasing use of sonography in the initial evaluation of patients with abdominal disease may allow the detection of unexpected tumor within the abdominal cavity. Easiness of sonographic detection of bowel pathology, purposely or unexpectedly, warrants the inclusion of bowel loops during ultrasound examination when a patient complains of symptoms indicating diseases of the bowel. In patients complaining of acute abdominal symptoms or nonspecific gastrointestinal symptoms and showing signs such as abdominal pain, diarrhea, hematochezia, change of bowel habit, or bowel obstruction, sonography may reveal the primary causes and may play a definitive role in making a diagnosis. On ultrasonography, abnormal lesions may appear as fungating mass with eccentrically located bowel lumen (pseudokidney sign) or symmetrical or asymmetrical, encircling thickening of the colonic wall (target sign). In patients with mass or wall thickening detected on ultrasonography, additional work-up such as barium study, CT or endoscopy would be occasionally necessary for making a specific diagnosis.
Abdomen, Acute/ultrasonography ; Aged ; Appendicitis/ultrasonography ; Colorectal Neoplasms/ultrasonography ; Diverticulitis/ultrasonography ; Female ; Gastrointestinal Diseases/ultrasonography+ACo- ; Gastrointestinal Neoplasms/ultrasonography ; Human ; Inflammatory Bowel Diseases/ultrasonography ; Intestinal Obstruction/ultrasonography ; Intestinal Perforation/ultrasonography ; Intestines/ultrasonography ; Male ; Stomach/ultrasonography ; Ultrasonography/instrumentation

Abdomen, Acute ; diagnosis ; diagnostic imaging ; therapy ; Female ; Humans ; Infant ; Intussusception ; diagnosis ; diagnostic imaging ; therapy ; Ultrasonography

The initial radiologic evaluation of a patient with acute abdominal symptoms begins with plain abdominal radiographs. Plain abdominal radiographs are helpful for the diagnosis of intestinal obstruction and pneumoperitoneum. However, cross-sectional imaging modalities, such as ultrasonography or computed tomography, are necessary for specific diagnosis of acute abdomen. Ultrasonography is a non-invasive and comfortable tool for patients visiting emergency room. This article describes the ultrasonographic findings of most common diseases presenting with acute abdominal symptoms.
Abdomen, Acute* ; Diagnosis ; Emergency Service, Hospital ; Humans ; Intestinal Obstruction ; Pneumoperitoneum ; Ultrasonography*

PURPOSE: To evaluete the sonographic features of ovarian mass torsion. MATERIALS AND METHODS: We evaluated the sonographic findings in 22 cases of torsioned cystic ovarian mass, benign teratoma(n=21), and normal ovary (n=l) confirmed surgically on pathologically. We classified the ovarian mass into two groups as sonographic ally cystic (n=15) or non-cystic mass(n=6). The patients were 17-72 years old(mean:36.9). We retrospectively reviewed US examination with respect to (1) free fluid in Douglas pouch, (2)pelvic mass & mass wall thickening, (3)dilated uterine tube, (4)prominent follicles, (5) engorged vessels, and (6)beak-like echo in torsion site. The combined conditions of torsion were uterine myoma(n=l) and intrauterine pregnancy(n=3). RESULTS: In sonogram, sonographic cystic mass (n=15) group showed (1)free fluid in Douglas pouch (9/15), (2)mass wall thickening(6/15), (3)dilated uterine tube(2/15), and sonographic non-cystic mass(n=6) group showed (1) free fluid in Douglas pouch (3/6). In sonogram, torsion of the normal ovary(n=1) showed (1) free fluid in Douglas pouch, and (2) prominent follicles. CONCLUSION: If sonogram of reproductive aged women with acute abdomen show free fluid in Douglas pouch and pelvic mass with wall thickening, ovarian mass torsion is suggested. But clinical features of acute abdomen and clinical diagnosis of torsion are more important than sonographic features.
Abdomen, Acute ; Diagnosis ; Douglas' Pouch ; Fallopian Tubes ; Female ; Humans ; Ovary ; Retrospective Studies ; Ultrasonography*

PURPOSE: Diagnosis of acute abdomen in infants and children is difficult. The aim of this study is to evaluate the usefulness of sonography in the children suffering from acute abdominal pain. METHODS: From January 2001 through July 2002, abdominal sonography was carried out in 265 children who had abdominal pain, vomiting, or irritability. The suspected diagnosis were acute appendicitis, intussusception, congenital pyloric obstruction, inguinal hernia, and illeocolitis. Medical records were reviewed retrospectively for age, sex, sonographic diagnosis, and the impact of the sonography in the treatment was evaluated by comparing the sonographic diagnosis with the final diagnosis (guidance for treatment). RESULTS: Among 265 patiens, the sex ratio (male:female) was 1.7:1. According to the findings of sonographic studies, mesenteric lymphadenitis (40.8%) was the most common diagnosis and was followed by acute appendicitis (21.9%), normal abdomen (19.2%), intussusception (14.3%), ileus (3.4%), and epididymitis (0.4%). In 259 of the 265 patients, sonography helped guideline for treatment (97.7%). CONCLUSION: Sonography is very useful in the diagnosis and establishing the treatment guideline of pediatric patients with acute abdomen.
Abdomen ; Abdomen, Acute* ; Abdominal Pain ; Appendicitis ; Child ; Diagnosis ; Emergencies* ; Epididymitis ; Hernia, Inguinal ; Humans ; Ileus ; Infant ; Intussusception ; Male ; Medical Records ; Mesenteric Lymphadenitis ; Retrospective Studies ; Sex Ratio ; Ultrasonography ; Vomiting

Spontaneous rupture of kidney is a rare condition which usually presents as an acute abdomen requiring prompt diagnostic evaluation and proper therapy. We experienced a 27-year-old pregnant woman hospitalized with complaint of right flank pain. Ultrasonography and DIP (shield lower abdomen) revealed multiple sandy renal stones and right caliectasis with extravasation of contrast media through renal fornices into perirenal space. We present a case of spontaneous rupture of kidney associated with multiple renal stones during pregnancy, successfully managed with temporary insertion of ureteral catheter.
Abdomen, Acute ; Adult ; Extravasation of Diagnostic and Therapeutic Materials ; Female ; Flank Pain ; Humans ; Kidney* ; Pregnancy* ; Pregnant Women ; Rupture, Spontaneous* ; Ultrasonography ; Urinary Catheters

An accessory spleen is often incidentally discovered in up to 20% of autopsies. However, it is exceedingly rare for this condition to result in an acute abdomen. In addition, torsion of an accessory spleen is extremely rare. In spite of this, the entity should be considered in the emergency department in the differential diagnosis of an acute abdomen associated with an intraperitoneal inflammatory mass. This report describes a case of acute torsion of an accessory spleen. A 26-year-old, previously health female was admitted to our hospital with severe abdominal pain and a palpable mass. Ultrasonography showed a well-defined ovoid, hypoechogenic, avascular mass. Computed tomography demonstrated a round, homogeneous hypodense mass with a whorling appearance and an engorged vascular structure in the left side of the mass. The presumptive diagnosis of a large exoenteric mass (small bowel or mesenteric origin) associated with mesenteric volvulus was made preoperatively. However, at laparotomy, the patient was found to have torsion and an infarction of an accessory spleen that had twisted on its long vascular pedicle.
Abdomen, Acute* ; Abdominal Pain ; Adult ; Autopsy ; Diagnosis ; Diagnosis, Differential ; Emergency Service, Hospital ; Female ; Humans ; Infarction ; Intestinal Volvulus ; Laparotomy ; Spleen* ; Ultrasonography

Emphysematous cholecystitis is an uncommon form of acute cholecystitis characterized by the presence of gas within the wall, lumen of the gall bladder or biliary ducts. Clinically it is very similar to ordinary farm. But since the risk of perforation is five times that expected from ordinary cholecystitis, early diagnosis and appropriate surgical treatment are important. We could diagnose these cases by the simple abdomen, abdominal ultrasound and abdominal CT by the presence of air in the lumen and the wall of the gall bladder. Percutaneous trans hepatic gall bladder drainage (PTGBD) for decompression was used because poor general condition of patients and later, we could successfully perform the cholecystectomy without any complication. We presented two cases of emphysematous cholecystitis with review of the relevant literature on the subject.
Abdomen ; Cholecystectomy ; Cholecystitis ; Cholecystitis, Acute ; Decompression ; Drainage ; Early Diagnosis ; Emphysematous Cholecystitis* ; Humans ; Tomography, X-Ray Computed ; Ultrasonography ; Urinary Bladder

PURPOSE: We evaluated the abdominal uttrasonographic findings of Salmonellosis. MATERIALS AND METHODS: This study included 64 patients who were confirmed as salmonellosis by blood culture. We retrospectively analyzed the abdominal ultrasonographic findings with particular attention to enlarged mesenteric lymph nodes(mesenteric lymphadenitis), thickening of bowel wall, especially terminal ileum and cecum(ileocecitis), hepatosplenomegaly, ascites, gallbladder wall thickening, and enlarged lymph nodes in porta hepatis. RESULTS: The 64 cases were observed as mesenteric lymph node enlargement(44 cases), wall thickening of the terminal ileum and cecum(36 cases), hepatomegaly and/or splenomegaly(42 cases), minimal ascites(8 cases), gallbladder wall thickening(6 cases), and enlarged lymph nodes in porta hepatis(4 cases). No abnormal finding was seen in 10 patients. CONCLUSION: The mesenteric lymph node enlargement, wall thickening of the terminal ileum and cecum, hepatomegaly and/or splenomegaly, minimal ascites, gallbladder wall thickening, and enlarged lymph nodes in porta hepatis are suggestive findings of salmonellosis on abdominal ultrasonography in patients with fever and acute abdomen.
Abdomen, Acute ; Ascites ; Cecum ; Fever ; Gallbladder ; Hepatomegaly ; Humans ; Ileum ; Lymph Nodes ; Retrospective Studies ; Salmonella Infections* ; Splenomegaly ; Ultrasonography