Abdominal Radiology - Paediatrics

Gastro-Intestinal

Abdominal Radiology

·        Should always be gas in the: 

o   Stomach. If not, then ask why. ?Oesophageal atresia without fistula to the bronchus. ?To sick to swallow 

o   Rectum

o   RLQ (Caecum)

·        Gas bubbles.  If only:

o   1: pyloric stenosis.  Do US to confirm (not barium meal) 

o   2: Duodenal atresia – “double bubble trouble”. Associated with Down‟s. Ante-natally: polyhydramnios (can‟t swallow) 

o   3: Jejunal atresia

o   Lots of bubbles but no normal caecal gas: Ileal atresia (Colonic atresia very rare)

·        Other signs: 

o   Gas on both sides of bowel wall ® wall stands out as opaque line ® Rigler‟s sign 

o   Malrotation: wandering small bowel below duodenum with barium meal. If corkscrew then ?malrotation with volvulus

·        Pneumatosis Intestinalis: gas bubbles in intestinal wall („string of pearls‟): if also in portal venous system (eg bubbles in liver) then necrotising enterocolitis