Abdominal ultrasound (pediatric clients)

ABDOMINAL ULTRASOUND

ABDOMINAL ULTRASOUND

An abdominal ultrasound uses reflected sound waves to produce a picture of the organs and other structures in the upper abdomen. Occasionally a specialized ultrasound is ordered for a detailed evaluation of a specific organ, such

as a kidney ultrasound.

Abdominal Ultrasound can evaluate:

Abdominal aorta , which is the large blood vessel (artery) that passes down the back of the chest and abdomen. The aorta supplies blood to the lower part of the body

and the legs.

The aorta stems from the heart, arches upward, and then extends down behind the heart and through the chest (thorax) and the abdomen areas. The aorta then branches out and becomes the iliac arteries, which provide blood

to the pelvis and legs.

Abdominal aorta:


Liver, which is a large dome- shaped organ that lies under the rib cage on the right side of the abdomen. The liver produces bile (a substance that helps digest fat), stores sugars, and breaks down many of the body's waste

products.

The liver is a large organ in the right upper part of the abdomen. It performs a range of complex and important functions that affect all body systems. Some of the specific functions of the liver include: Controlling the amounts of sugar (glucose), protein, and fat entering

the bloodstream.

LIVER:

LIVER:Removing bilirubin, ammonia, and other toxins from the blood. (Bilirubin is a by- product of the breakdown of hemoglobin from red blood cells.) Processing most of the nutrients absorbed by the intestines during digestion and converting those nutrients into forms that can be used by the body. The liver also stores some nutrients, such as vitamin A, iron, and

other minerals.

LIVER:

Producing cholesterol, substances that help blood clot, bile, and certain important proteins, such as albumin. Breaking down

(metabolizing) many drugs.


Gallbladder, which is a saclike organ beneath the liver. The gallbladder stores bile. When food is eaten, the gallbladder contracts, sending bile into the intestines to help in digesting food and absorbing fat-

soluble vitamins.

GALLBLADDER:

The gallbladder is a small sac under the liver that stores and concentrates bile, a fluid that helps the body digest fats. After a meal, the gallbladder contracts and releases bile through the common bile duct into the small

intestine.

Spleen, which is the soft, round organ that helps fight infection and filters old red blood cells. The spleen is located to the left of the stomach, just behind the lower left

ribs.


SPLEEN:

The spleen is an organ in the upper left side of the abdomen that filters the blood by removing old or damaged blood cells and platelets and helps the immune system by destroying bacteria and other foreign substances. It also holds extra blood that can be released into the circulatory system, if

needed.

SPLEEN:

The spleen is a useful but nonessential organ. It is sometimes removed (splenectomy) in people who have blood disorders, such as thalassemia or hemolytic anemia. If the spleen is removed, a person must get certain immunizations to help prevent infections that the spleen normally

fights.

Pancreas, which is the gland located in the upper abdomen that produces enzymes that help digest food. The digestive enzymes are then released into the intestines. The pancreas also releases insulin into the bloodstream; insulin helps

the body utilize sugars for energy.


PANCREAS:

The pancreas is an organ in the upper abdomen, behind the stomach and close to the spine, that produces substances (digestive enzymes) needed to break down and use food. The pancreas also produces insulin, the hormone that regulates sugar

(glucose) in the blood.

Kidneys, which are the pair of bean-shaped organs located behind the upper abdominal cavity. The kidneys remove wastes from the

blood and produce urine.


KIDNEYS:

The kidneys are organs located on either side of the spine, at the small of the back. Kidneys filter the blood and help balance water, salt, and mineral levels in the blood; they also produce hormones that help regulate blood

pressure and blood supply.

KIDNEYS:

Waste from the kidneys is carried out of the body in urine. Urine flows through tubes (ureters) to the bladder, where it is stored until a person is ready to urinate. The waste and urine then leave the bladder to exit the body through a

tube called the urethra.

WHY IS IT DONE?

•Determine the cause of abdominal pain.

•Detect, measure, or monitor an aneurysm in the aorta. An aneurysm may cause a large,

pulsing lump in the abdomen.

ANEURYSM:

An aneurysm is a bulging section in the wall of a blood vessel that has become stretched out and thin. As the wall of the blood vessel bulges out, it becomes weaker and may burst or rupture, causing bleeding. If an aneurysm in the brain bursts, it may cause a stroke. An aneurysm in a vessel that carries a lot of blood, such as the aorta, is often

fatal if it bursts.

WHY IS IT DONE?

Evaluate the size, shape, and position of the liver. An ultrasound may be done to evaluate jaundice and other problems of the liver, including liver masses, cirrhosis, fat deposits in the liver (called fatty liver), or abnormal liver

function tests.

Jaundice:

Jaundice is a condition in which the skin and whites of the eyes appear yellow because of the buildup of a yellow-brown pigment called bilirubin in the blood and skin. Bilirubin is produced by the breakdown of red blood cells. The liver normally gets rid of bilirubin in bile (a fluid that

helps the body digest fats).

CIRRHOSIS:

Cirrhosis is a potentially life- threatening condition that occurs when inflammation and scarring damage the liver. Alcohol abuse and chronic viral hepatitis are the most common causes of cirrhosis, but it can also be caused by medicines or by another disease (such as

hemochromatosis).

CIRRHOSIS:

Symptoms of cirrhosis include nausea, lack of appetite and weight loss, tiredness, and swelling in the legs and belly. If left untreated, severe cirrhosis can result in internal bleeding, yellowing of the skin and eyes (jaundice), unclear thinking,

hand tremors, and coma.

CIRRHOSIS:

Cirrhosis is treated by taking care of the underlying cause of the liver damage and by treating other problems, such as internal bleeding, that result from the liver damage. In some cases, a liver transplant may be possible.

WHY IS IT DONE?Detect gallstones, inflammation of the gallbladder (cholecystitis), or

blocked bile ducts.

GALLSTONES:

Gallstones are deposits like small stones that form in bile, a fluid that helps digestion; bile is stored in the gallbladder, a sac under the liver. Gallstones can develop in the gallbladder or in the bile ducts, which are tubes that carry bile to

the small intestine.

GALLSTONES:

Gallstones can be smaller than a grain of sand or as large as a golf ball. They generally do not cause problems unless they block a tube (duct) leading from the gallbladder to other organs. When this happens, abdominal pain and other symptoms develop

suddenly.

GALLSTONES:

Gallstones are common. They develop when there is too much cholesterol in the bile for the cholesterol to remain dissolved or when the gallbladder does not empty as quickly as it should. Gallstones are most common in women, people who are obese, older people, people with sickle cell disease, people who have lost weight rapidly, and people who are taking certain

medicines.

GALLSTONES:Most people who have gallstones do not have any symptoms and do not need treatment. If symptoms develop, they usually will include pain in the upper abdomen and are rarely life-threatening. However, pain from gallstones can vary in intensity and may cause vomiting. Gallstones that cause symptoms usually are treated with surgery to remove the gallbladder

(cholecystectomy).

Abdominal ultrasound showing the gallbladder

Figure 1 shows a normal gallbladder on ultrasound. Figure 2 shows a large

gallstone in the gallbladder.

WHY IS IT DONE?Detect kidney stones.

KIDNEY STONES:Kidney stones are made of salts and minerals in the urine that stick together to form small "pebbles." They are usually painless while they remain in the kidney, but they can cause severe pain as they break loose and travel through narrow tubes (ureters) to

exit the body during urination.

KIDNEY STONES:

Symptoms of a kidney stone include severe pain on one side of the back, just below the rib cage (flank pain). The pain may spread to the lower abdomen, groin, and genital area. Other symptoms include blood in the urine (hematuria), painful or frequent urination (dysuria), and nausea and

vomiting.

KIDNEY STONES: A kidney stone is usually treated by

increasing fluid intake and taking medications to relieve pain until the stone has passed. This typically occurs within a few days. If the stone seems unlikely to pass on its own or is causing severe pain, treatment options include a shock wave treatment (lithotripsy), which can break up a large stone into smaller pieces that are easier to pass,

or very rarely, surgery.

WHY IS IT DONE?Determine the size of an enlarged spleen and look for damage or

disease.

WHY IS IT DONE?Detect problems with the pancreas, such as pancreatitis or pancreatic

cancer.

Pancreatitis:

Pancreatitis is an inflammation of the pancreas, which is an organ in the upper abdomen that makes insulin and digestive enzymes. Pancreatitis may cause sudden,

severe abdominal pain.

Pancreatitis:Pancreatitis is most commonly caused by excessive use of alcohol or by a blockage of the tube (duct) that leads from the pancreas to the beginning of the small intestine (duodenum), usually by a gallstone. Other causes include an infection, an injury, or certain medicines. It may develop suddenly (acute), or it may be a long- term,

recurring (chronic) problem.

Pancreatitis:

Treatment in the hospital includes pain medicine and fluids given through a vein (IV) until the inflammation goes away. Nutrition is given through a tube to avoid stimulating the pancreas. Although most people recover fully from pancreatitis, complications such as bleeding, infection, or organ failure may

develop.

WHY IS IT DONE?

Determine the cause of blocked urine flow in a kidney. A kidney ultrasound may also be done to determine the size of the kidneys, detect kidney masses, detect fluid surrounding the kidneys, investigate causes for recurring urinary tract infections, or evaluate the condition of transplanted kidneys.

Urinary tract infection

A urinary tract infection (UTI) is an infection in the organs and tubes that process and carry urine out of the body. Most UTIs are either bladder infections (cystitis) or

kidney infections (pyelonephritis).

UTIs occur most often when bacteria begin to grow in the kidneys, the bladder, the tubes that carry urine from the kidneys to the bladder (ureters), or the tube that carries urine from the bladder to outside of the body (urethra). Sexual intercourse may introduce bacteria into the urinary tract, especially in women. Catheterization is a common source of bacterial infection in people who are hospitalized or live in long- term care

facilities.

Urinary tract infection

Urinary tract infectionAn adult or older child with a UTI may have :

Pain or burning during urination .

An urge to urinate frequently but usually passing only small quantities of urine .

Dribbling (inability to control urine release) .

Reddish or pinkish urine .

Foul-smelling urine .

Cloudy urine.

Determine whether a mass in any of the

abdominal organs (such as the liver) is a solid tumor or a simple fluid-

filled cyst.

WHY IS IT DONE?

Cyst:A cyst is a saclike structure in the body. Cysts usually are filled with fluid, which may be blood, clear

fluid, or pus .

A cyst can be normal, abnormal, or, in rare cases, cancerous. In some cases, a cyst may be drained either with a needle or by cutting it open, or it may be removed

entirely .

WHY IS IT DONE?

Determine the condition of the abdominal organs after an accident or abdominal injury and look for blood in the abdominal cavity. However, computed tomography (CT) scanning is more commonly used for this purpose because it is more precise than

abdominal ultrasound.

Ct/cat scan:

A computed tomography (CT) scan uses X-rays to make detailed pictures of structures inside of the

body.

A CT scan can be used to study any body organ, such as the liver, pancreas, intestines, kidneys, adrenal glands, lungs, and heart. It also can study blood vessels,

bones, and the spinal cord.

Ct/cat scan:

Guide the placement of a needle or other instrument during a biopsy.

WHY IS IT DONE?

Biopsy:

A biopsy is a sample of tissue collected from an organ or other part of the body. A biopsy can be done by cutting or scraping a small piece of the tissue or by using a needle and syringe to remove a sample, which is then examined for abnormalities, such as cancer, by a doctor trained to look at tissue samples

(pathologist).

Tell your doctor if you have had a barium enema or a series of upper GI (gastrointestinal) tests within the past 2 days. Barium that remains in the intestines can

interfere with the ultrasound test

preparation

Other preparations depend on the reason for the abdominal ultrasound test you

are having .

For ultrasound of the liver, gallbladder, spleen, and pancreas, you may be asked to eat a fat-free meal on the evening before the test and then to avoid eating for 8 to 12 hours before the test.

preparation

preparation For ultrasound of the kidneys, you may

not need any special preparation. You may be asked to drink 4 to 6 glasses of liquid (usually juice or water) about an hour before the test to fill your bladder. You may be asked to avoid eating for 8 to 12 hours before the test to avoid gas buildup in the intestines. This could interfere with the evaluation of the kidneys, which lay behind the stomach

and intestines.

preparation

For ultrasound of the aorta, you may need to avoid eating for 8 to 12

hours before the test.

Procedure:

This test is done by a doctor who specializes in performing and interpreting imaging tests ( radiologist) or by an ultrasound technologist (sonographer) who is supervised by a radiologist. It is done in an ultrasound room in a

hospital or doctor's office.

Procedure:

You will need to remove any jewelry that might interfere with the ultrasound scan. You will need to take off all or most of your clothes, depending on which area is examined (you may be allowed to keep on your underwear if it does not interfere with the test). You will be given a cloth or paper covering to

use during the test.

You will lie on your back (or on your side) on a padded examination table. Warmed gel will be spread on your abdomen to improve the quality of the sound waves. A small handheld unit, called a transducer, is pressed against your abdomen and moved back and forth over it. A picture of the organs and blood vessels can be seen on a

video monitor.

Procedure:

You may be asked to change positions so additional scans can be made. For a kidney ultrasound, you may be asked to lie on your

stomach.

Procedure:

You need to lie very still while the ultrasound scan is being done. You may be asked to take a breath and hold it for several seconds during the scanning. This lets the sonographer see organs and structures, such as the bile ducts, more clearly because they are not

moving.

Procedure:

Holding your breath also temporarily pushes the liver and spleen lower into the belly so they are not hidden by the lower ribs which makes it harder for the

sonographer to see them clearly.

Procedure:

Abdominal ultrasound usually takes 30 to 60 minutes. You may be asked to wait until the radiologist has reviewed the information. The radiologist may want to do additional ultrasound views of

some areas of your abdomen.

Procedure:

Results:

An abdominal ultrasound uses reflected sound waves to produce a picture of the organs and other

structures in the abdomen.

Normal:

The size and shape of the abdominal organs appear normal. The liver, spleen, and pancreas appear normal in size and texture. No abnormal growths are seen. No

fluid is found in the abdomen.

Normal:The diameter of the aorta is normal

and no aneurysms are seen.

The thickness of the gallbladder wall is normal. The size of the bile ducts between the gallbladder and the small intestine is normal. No

gallstones are seen.

Normal:

The kidneys appear as sharply outlined bean-shaped organs. No kidney stones are seen. No blockage to the system draining

the kidneys is present.

abNormal:An organ may appear abnormal because of inflammation, infection, or other diseases. An organ may be smaller than normal because of an old injury or past inflammation. An organ may be pushed out of its normal location because of an abnormal growth pressing against it. An abnormal growth (such as a tumor) may be seen in an organ. Fluid in the abdominal cavity (ascites) may be

seen.

Normal aorta

Abnormal aorta

abNormal

The liver may appear

abnormal, which may

indicate liver disease (such as cirrhosis or

cancer).

abNormal

The walls of the gallbladder may be thickened, or fluid may be present around the gallbladder, which may indicate inflammation. The bile ducts may be enlarged because of blockage (from a gallstone or an abnormal growth in the pancreas). Gallstones may be seen inside the

gallbladder.

abNormal

The kidneys may be enlarged because of urine that is not draining properly through the ureters. Kidney stones are seen within the kidneys (not all stones can be seen with ultrasound).

abNormal

An area of infection (abscess) or a fluid-filled cyst may appear as a round, hollow structure inside an organ. The spleen may be ruptured (if an injury to the

abdomen has occurred).

Contraindications:

Factors that can interfere with your test and the accuracy of the results include:

Stool, air (or other gas), or contrast material (such as barium) in the

stomach or intestines .

The inability to remain still during the test .

Extreme obesity.

Having an open wound in the area being viewed.

Nursing responsibilities

Assist the client with a gown, robe and slippers. Make sure the client has no internal metal devices or external metal objects because it will interfere with diagnostic

findings.


For best visualization, schedule abdominal ultrasound before any

examinations that use barium.

Instruct the client undergoing abdominal ultrasonography to drink five to six full glasses of fluid approximately 1 to 2 hours before the test. To ensure a full bladder, they should not urinate until after

the test is done.


Explain that acoustic gel is applied over the area where the

transducer is placed.


Abdominal ultrasound during pregnancy

Abdominal ultrasounds are also used in pregnancy to check on the baby and potentially detect concerns with the pregnancy. It is a reliable way to check on a baby's gestational age, growth, detect multiple gestations and establish the placental location. Early identification of problems in the pregnancy can direct medical care for

better pregnancy outcomes.

First trimester

An ultrasound in the first trimester, performed before 13.5 weeks of pregnancy, is used to confirm the viability of the pregnancy and determine the gestational age of the embryo. A standard ultrasound, also called a level I, is

generally used .

First trimester

Sometimes, a transvaginal ultrasound is used if the clinician cannot get a good look though the abdomen. The first trimester ultrasound has the ability to detect multiple gestations, ensure that the embryo is not outside the

uterus and detect the heartbeat.

Second and Third Trimester

Standard ultrasounds performed in the second and third trimester look at the age and size of the fetus, how many babies are present, where the placenta is located and detect the heartbeat. This evaluation can also determine if the normal amount of amniotic fluid is present and look at the

basic fetal anatomy .

Second and Third Trimester

A second trimester ultrasound usually takes place between 18 and 20 weeks gestation. Woman may or may not have a third trimester ultrasound, depending on the recommendations of her

doctor.

Specialized Ultrasound Evaluations

If a potential birth defect is identified, a more detailed ultrasound may be ordered. Called a "level II" ultrasound, the evaluation takes a careful look at the baby's size, head circumference and internal organs--including the heart,

stomach and kidneys .

The clinician also looks at the length and structure of the arms and leg bones, the spine and the face. Depending on the type of birth defect suspected, more frequent ultrasounds or a 3D/4D ultrasound may be performed. Changes may be made to pregnancy management, the way the baby is delivered and creating a medical care plan for after the baby is

born.

Specialized Ultrasound Evaluations

Types of UltrasoundsA standard ultrasound is the most common type. Some practices have a Doppler ultrasound that evaluates blood flow though the baby. This includes blood flow in and out of the umbilical cord. 3D ultrasounds provide a "picture-like" image, unlike a standard, 2D ultrasound that only shows a

cross-section of the baby .

Types of Ultrasounds

A 4D ultrasound includes video, allowing a real-time look at the fetus. The 3D and 4D ultrasounds are often used to evaluate specific types of suspected birth defects,

such as cleft lip

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Abdominal ultrasound (pediatric clients)

Health & Medicine

Transcript of Abdominal ultrasound (pediatric clients)