Acute Paediatric Abdomen

Ultrasound scanning guidelines

Acute Paediatric Abdomen If a request is received for acute abdominal pain and the area is vague and non-specific, a full assessment of the abdomen is required. This is also the case with babies and younger children when unable to get a verbal indication of the region of the pain and clinical assessment may be difficult. Assess: Upper Abdomen pancreas aorta gallbladder/duct liver kidneys and adrenals spleen Large bowel (to rule out intussusception) - ascending, transverse, descending colon and rectum RIF/appendix SMV/SMA relationship Mesentery (for lymph nodes) Bowel wall (for thickening) Documentation: Upper Abdomen transverse pancreas long aorta gallbladder - long and trans (include wall thickness) bile duct calibre Liver - long and trans views adrenals - long and trans views of both kidneys - long and trans views of both spleen - long and trans views Large Bowel trans and long vies of ascending colon transverse colon descending colon rectum long midline view of Pouch of Douglas trans and long views of terminal ileum, including wall thickness measurement colour Doppler of affected bowel If intussusception seen At intussusception site: trans view + - clipstore long view + - clipstore trans view with colour Doppler Appendix / RIF long appendix trans appendix with diameter measurement - with/without compression pelvis long for free fluid non-compressible appendix +/- clipstore of compression SMV/SMA relationship trans SMV/SMA view +/- colour Doppler Mesentery trans and long views of mesentery document and measure any lymph nodes seen > 5mm in diameter Assess lymph nodes with colour Doppler intanodal blood flow and some blodd flow in the rissues between the nodes may be seen

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