tailieunhanh - Paediatric Radiography - part 5

Nguyên nhân gây chảy máu đường ruột được liệt kê trong Bảng . Scintigraphy là phương thức hình ảnh của sự lựa chọn để xác định vị trí nguồn gốc của một chảy máu đường ruột. Tuy nhiên, ưu tiên cho nghiên cứu Bari, nội soi và siêu âm có thể chứng minh những thay đổi có liên quan với bệnh viêm ruột hoặc intussusception9. | The abdomen 77 Table Causes of gastrointestinal bleeding16. Age Cause of bleeding Neonate Necrotising enterocolitis Infectious colitis Infant Stress ulcer Meckel s diverticulum Intussusception Child Polyp Inflammatory bowel disease Gastrointestinal bleeding Causes of intestinal bleeding are listed in Table . Scintigraphy is the imaging modality of choice to locate the source of an intestinal bleed. However endoscopy in preference to barium studies and ultrasound may demonstrate changes associated with inflammatory bowel disease or intussusception9. Constipation Abdominal radiography will show extensive faecal material as a normal feature in many children and therefore imaging is not helpful in the diagnosis or management of constipation and should not be performed routinely9. Chronic diarrhoea Chronic diarrhoea is a non-specific sign of abdominal pathology. Clinical diagnosis relies heavily on patient medical history and the pathological assessment of stool specimens. Barium examinations if undertaken may show signs of inflammatory bowel disease. However for many patients presenting with diarrhoea as a result of a small bowel mucosal disorder only a non-specific malabsorption pattern thickened mucosal folds bowel wall oedema barium flocculation will be seen6 and in these cases more invasive diagnostic investigations . jejunoscopy should be considered. Gastric dilatation An over-distended gas-filled stomach can result from air swallowing during crying and is therefore a common finding on plain film radiographs of young infants and children. Only when little or no air is seen in the bowel distal to a distended stomach should concerns be raised and gastric outlet obstruction considered4. 78 Paediatric Radiography Radiographic technique for the abdomen Plain film abdominal radiography There is no specific preparation for radiography of the paediatric abdomen. However general preparation such as providing a procedural explanation will be necessary in order to