Abdominal ultrasonography: clinical significance in the pediatric out-patients' clinics

Ultrasound is the basic first-line investigation for an enormous variety of abdominal symptoms in pediatric patients, This is because it is non-invasive and because of its accessible nature, and its success in terms of diagnosis depending on the skill of the operator, The objective of this prospective study is to further elucidate the role of abdominal ultrasonography for screening purposes as well as investigating the relevance of sonographic findings in patients with clinical problems related to the abdomen. This work was conducted on 10114 infants and children [4900 males and 5214 females], ranging in age from 1 day to 12 years. They were referred to the various outpatients' clinics, Cairo University Children's Hospital. Proper history taking, thorough clinical examination, and ultrasonography of the abdomen and basal parts of the thorax were done for all patients. Other investigations were done for certain cases to reach the final diagnosis. Patients were divided into 2 groups: Group I consisted of 2668 patients [26.4%] without specific symptoms in the abdomen, it represented the screening group. Group II consisted of 7446 patients [73.6%] with abdominal symptoms and therefore well-defined sonographic requests. The results revealed that 60% of the whole group had pathologic sonographic findings. Pathological findings were discovered in 61.7%, 59.3% of group I and group II patients respectively. According to their individual influence on the patient's disease course, sonographic findings were subdivided into 3 categories: Relevant, prospectively relevant and irrelevant findings. In each of group I, and group I1 patients these findings constituted 47.8%, 76% and 36%, 10.6% and 16.2%, 13.3% of total findings in each group respectively, The difference between both groups was statistically significant, Most of relevant findings [81%] were detected in group I1 patients as compared to 19% in group I, The nephrology clinic was ranked as the No 1 clinic regarding the frequency of pathologic findings discovered in patients referred from it [27%]. Also, the highest frequency of relevant findings was detected in patients from the hepatology [87%] and nephrology [82%] clinics

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Conclusion: abdominal ultrasonography can detect various relevant findings in asymptomatic out- patients as well as in patients with a clinical problem related to the abdomen. Also, ultrasonography completes the physical examination, adding a substantial amount of clinically important information to the patient's medical record and physician's report