About Dr. Stacy

The survey methodology Investigation of possible child should be painless, or at least no more painful than a clinical examination. Pronounced negative reaction of the child to inspect greatly complicates research, and in this case it makes sense to him in a state of sleep medication child.

Study with a full bladder is considered optimal, particularly for girls, puberty to avoid acute surgical pelvic pathology. Further inspection of structures aimed right iliac region makes sense to spend a moderate bladder filling as crowded bubble compression impedes the anterior abdominal wall. Continue reading

Echographic study of pediatric patients with acute abdominal syndrome convex probe is advantageously carried out at a frequency of 5 MHz and 7.5-MHz linear transducer. Both sensors combine sufficient depth of penetration (about 6-10 cm) with high image quality. Sensor 5 MHz is used for the scoping study and the sensor is 7.5 MHz to produce detailed images of structures right iliac region.

Using the last sensor is preferred, since during the compression of the anterior abdominal wall transformed inflammatory appendix is typically at a depth of not more than 20 mm from the skin surface. According to some authors, it is optimal to use a T-sensor. The shape and small size, in combination with the configuration of the beam makes it preferable for use in pediatric patients.

Other neoplasms Retinoblastoma – the most common intraocular malignant tumor that occurs predominantly in early childhood. Sonography is an informative diagnostic method to determine extent of tumor invasion, tumor judge the dynamics of tumor growth. Ultrasound picture is characterized by the presence of space-occupying lesion on the retina with fuzzy rough hilly contours of the inhomogeneous structure with hyperechoic inclusions.

Most of the children have a retinal detachment of varying severity. In healthy children, unaltered appendix in most cases are either not visible or determined with great technical difficulties, due to the elasticity of its walls (lack of rigidity in compression sensor) and small size. Unchanged appendix can be identified in 5% zdorovyhdetey. It is a structure with a distinctive tubular shape layered structure amenable to compression, easily dislodged. At ultrasound appendix in children has three layers. Continue reading

Tumor genital Typical ultrasound picture of malignant testicular tumors is to increase its size, irregular shape of the tumor node, clear irregular contours, chaotic internal structure, the low intensity of the reflection. Malignant tumors of the genital organs of girls in 86% of cases are localized in the ovaries, 10% – in the moisture – deprivation and cervix, 3% – in the body of the uterus.

In rare cases, the tumor is localized in the outer opening of the urethra and vulva. On morphological characteristics are most common Hermine – gene ovarian tumors (80%) and sex cord stromal tumors (13%). Epithelial tumors (ovarian cancer) are not characteristic of childhood and account for 7%. Ultrasound picture of ovarian tumors characterized by the presence of the tumor site with clear smooth contours of the inhomogeneous structure, with zones without reflections, alternating with areas of parenchymal density. In most cases, the tumor is larger, performs the pelvis and lower abdomen, causing deformation and displacement of adjacent organs and tissues. Continue reading

Ultrasound pictures of tumor lesions of the bladder characterized by irregular thickening of the mucosa of 1-3 cm, and exophytic tumors localized in the region of the neck, in the lateral and front and rear walls of the bladder. In rare cases (17%) tumor growth and has extracystic defined as hummocky node parenchymal density, commonly adjacent to the wall of the bladder, causing displacement and deformation.

Tumor pelvic Presakralnye neuroblastoma occur in 10% of cases, usually occupy the pelvic cavity, slip forward and distort the bladder and rectum, and squeezed laterally displace the ureters. For peritoneal neuroblastoma most aggressive, often affects the surrounding organs and tissues, often metastasis – ruet in retroperitoneal lymph nodes and distant organs. In determining the prevalence BOAD – Inorganic bus tumors on the diaphragm, adrenal gland and the skeleton is most informative CT.

In determining the incidence of retroperitoneal neuroblastoma on the kidneys, retroperitoneal lymph nodes and great vessels diagnostic capabilities of CT angiography and equal. Angiography reveals successful defeat (in the form of direct ingrowth) liver, spleen, pancreas, mesentery, peritoneum. Continue reading

At the level of the kidneys The greatest number of neuroblastomas Inorganic located on the kidneys, and depending on a bilateral or unilateral location gives semi-oval or spindle-shaped shadow, adjacent to the spine, and in 20% of cases occur calcifications. Often along the outer contour of the tumor revealed a shadow moved away and internally rotated kidneys. By arranging the largest tumor diameter above or below the renal hilum it moves not only laterally, but also upward or downward, respectively.

Thus, the most typical signs of excretory urography with neuroblastoma – stretching and lateral displacement of the renal lohanoch – ing system and ureter. Tumor vessels of the lumbar artery system, the high frequency of involvement of the great vessels (ingrowth into the wall of the inferior vena cava to 12 times more frequently than in other tumors, and in the aortic wall – 3 times more likely) are typical for angiography – cific pattern of retroperitoneal neuroblastoma. Expansion and displacement of adrenal arteries feeding ing neoplasm downward shift of the renal arteries distinguish an adrenal gland tumor.

Visual signs of tumor lesion volume I would like to emphasize that the visual signs of tumor lesion volume of the different organs, vneorgannye changes do not have specific features. It is impossible to echograms radiographs talk about the morphological nature of the lesion. Only a combination of clinical and visual signs may suggest the presence of space-occupying lesions.

“Gold standard” diagnosis remains biopsy, histological examination. Illustration of this can serve as a history of the disease girl 8 years, suffering from diabetes severe. By ultrasound in the retroperitoneal space on both sides of her determined bulk density around the upper poles of the kidneys, which has slipped and squeezed respectively liver, IVC and tail of the pancreas. In addition, the lower pole of the right kidney was defined hypoechoic, homogeneous, non-vascular formation with clear smooth contours. Fixed small amount of free fluid in the abdominal cavity. Continue reading

Difficulties for the diagnosis The greatest difficulty for the diagnosis of tumors represent verhnemedialnyh departments kidney imitating painting retroperitoneal neuroblastoma, as well as tumors, leading to inhibition of the function of the affected kidney. Abdominal angiography, aortography including, most effective in the diagnosis of nephroblastoma and solving operational hundred – coding tumor.

If you suspect a bilateral nephroblastoma, abnormal swelling (including horseshoe) kidneys, with the defeat of one kidney in conjunction with the contralateral non-tumor disease – General kidneys must abandon sequential use of other methods of diagnosis, except angiography, which has the most informative (93%) in identifying extent of the tumor and indispensable when planning surgical treatment. Continue reading

Tumor abdominal When abdominal form of lymphosarcoma in children first and mandatory in complex diagnostic studies should be ultrasound. The table presents data on the frequency of occurrence of different variants of tumor localization.

Zhelutska primary lesion is rare in children, unlike adults, who defeated zhelutska 53.5% of patients with lymphosarcoma. X-ray picture of lymphosarcoma zhelutska characterized by thickening of the mucous folds, chaotic orientation, rigidity of the wall at the site lesions, impaired motility and evakuatsr – function. Continue reading