PEDIATRIC ABDOMEN UPDATED FINAL EXAM
QUESTIONS AND CORRECT ANSWERS
General Pediatric Scanning Considerations - CORRECT ANSWERS Always use warm gel
Keep infant warm and secure
Wrap blankets around infant
Use as little gel as possible
Remove gel as soon as possible; it gets cold quickly
General Pediatric Scanning Considerations - CORRECT ANSWERS "Bottle, binky, and
diaper"
Dip binky into sugar solution; may repeat while scanning until able to give milk/formula.
Examine gallbladder and pancreas quickly, then give infant bottle for remainder of examination.
Always keep dry diaper on infant.
Use noisy bright colored toys, stickers, keys.
Two sonographers to one child is preferred.
General Pediatric Scanning Considerations - CORRECT ANSWERS Transducers
Use highest frequency transducer for area imaged.
Linear, curved array, or sector
For better resolution, use sequential focusing and zoom instead of decreasing depth.
0-1 yr: use 7.5 MHz linear
1-2 yr: use 5-7.5 MHz linear, curved array, or sector
2+ yr: use 5 MHz sector or linear
General Pediatric Scanning Considerations - CORRECT ANSWERS Take breaks
,Give child a rest.
Let mother hold child until calm.
Feasible to allow child to lie next to mother on stretcher to continue exam or have mom hold
child.
Cell phones area a great distraction.
Older child
Explain procedure before child undresses.
Have mother and child touch transducer and gel and be ready to "watch the movies."
Pediatric Ultrasound Examination Prep Abdominal Ultrasound - CORRECT ANSWERS 0-2
yr: NPO 4 hr
3-5 yr: NPO 5 hr
6+ yr: NPO 6 hr
Pelvic Ultrasound
0-9 yr: Plenty of juice or water 30 minutes before examination and no voiding.
10+ yr: 32 oz water 1 hour before examination. No voiding.
LIVER - CORRECT ANSWERS Size and texture of the liver should be evaluated.
Right hepatic lobe should not extend more than 1 cm below costal margin in young infant
without pulmonary hyperaeration; should not extend below right costal margin in older infants
and children.
Echogenicity: Normally low to medium homogenicity with clear definition of portal venous
vasculature
See textbook Figure 26-1, A-H for images of normal pediatric liver.
BILIARY SYSTEM - CORRECT ANSWERS Careful evaluation of biliary system to exclude
ductal dilatation
, Common bile duct - CORRECT ANSWERS <1 mm in neonates
<2 mm in infants up to 1 year old
<4 mm in older children
<7 mm in adolescents and adults
GALLBLADDER - CORRECT ANSWERS GB size and wall thickness should be assessed.
Infants <1 year of age: Length is 1.5 to 3 cm; in older children length is 3 to 7 cm.
Length of GB should not exceed length of the kidney.
Smooth-walled anechoic structure without internal echoes
Pericholecystic fluid should not be present.
PANCREAS - CORRECT ANSWERS Examined for size, echotexture, dilatation of pancreatic
duct
Pancreatic head should measure 1.0 to 2.2 cm; the body, 0.4 to 1.0 cm; and tail, 0.8 to 1.8 cm.
Pancreatic duct should not exceed 1 to 2 mm.
Size of pancreas should increase with age.
Normal texture: Hypoechoic compared with normal liver texture as little fatty tissue has invaded
islets of Langerhans.
SPLEEN - CORRECT ANSWERS Size and texture should be evaluated.
Upper limits of normal length ranges from 6.0 cm in infants <3 months old to 12 cm in children
>12 years of age.
PORTAL VEIN - CORRECT ANSWERS Diameter: May be helpful in determining presence of
portal hypertension
Mean PV measurement: 8.5 mm in children <10 years of age; 10 mm in patients 10 to 20 years
old.
QUESTIONS AND CORRECT ANSWERS
General Pediatric Scanning Considerations - CORRECT ANSWERS Always use warm gel
Keep infant warm and secure
Wrap blankets around infant
Use as little gel as possible
Remove gel as soon as possible; it gets cold quickly
General Pediatric Scanning Considerations - CORRECT ANSWERS "Bottle, binky, and
diaper"
Dip binky into sugar solution; may repeat while scanning until able to give milk/formula.
Examine gallbladder and pancreas quickly, then give infant bottle for remainder of examination.
Always keep dry diaper on infant.
Use noisy bright colored toys, stickers, keys.
Two sonographers to one child is preferred.
General Pediatric Scanning Considerations - CORRECT ANSWERS Transducers
Use highest frequency transducer for area imaged.
Linear, curved array, or sector
For better resolution, use sequential focusing and zoom instead of decreasing depth.
0-1 yr: use 7.5 MHz linear
1-2 yr: use 5-7.5 MHz linear, curved array, or sector
2+ yr: use 5 MHz sector or linear
General Pediatric Scanning Considerations - CORRECT ANSWERS Take breaks
,Give child a rest.
Let mother hold child until calm.
Feasible to allow child to lie next to mother on stretcher to continue exam or have mom hold
child.
Cell phones area a great distraction.
Older child
Explain procedure before child undresses.
Have mother and child touch transducer and gel and be ready to "watch the movies."
Pediatric Ultrasound Examination Prep Abdominal Ultrasound - CORRECT ANSWERS 0-2
yr: NPO 4 hr
3-5 yr: NPO 5 hr
6+ yr: NPO 6 hr
Pelvic Ultrasound
0-9 yr: Plenty of juice or water 30 minutes before examination and no voiding.
10+ yr: 32 oz water 1 hour before examination. No voiding.
LIVER - CORRECT ANSWERS Size and texture of the liver should be evaluated.
Right hepatic lobe should not extend more than 1 cm below costal margin in young infant
without pulmonary hyperaeration; should not extend below right costal margin in older infants
and children.
Echogenicity: Normally low to medium homogenicity with clear definition of portal venous
vasculature
See textbook Figure 26-1, A-H for images of normal pediatric liver.
BILIARY SYSTEM - CORRECT ANSWERS Careful evaluation of biliary system to exclude
ductal dilatation
, Common bile duct - CORRECT ANSWERS <1 mm in neonates
<2 mm in infants up to 1 year old
<4 mm in older children
<7 mm in adolescents and adults
GALLBLADDER - CORRECT ANSWERS GB size and wall thickness should be assessed.
Infants <1 year of age: Length is 1.5 to 3 cm; in older children length is 3 to 7 cm.
Length of GB should not exceed length of the kidney.
Smooth-walled anechoic structure without internal echoes
Pericholecystic fluid should not be present.
PANCREAS - CORRECT ANSWERS Examined for size, echotexture, dilatation of pancreatic
duct
Pancreatic head should measure 1.0 to 2.2 cm; the body, 0.4 to 1.0 cm; and tail, 0.8 to 1.8 cm.
Pancreatic duct should not exceed 1 to 2 mm.
Size of pancreas should increase with age.
Normal texture: Hypoechoic compared with normal liver texture as little fatty tissue has invaded
islets of Langerhans.
SPLEEN - CORRECT ANSWERS Size and texture should be evaluated.
Upper limits of normal length ranges from 6.0 cm in infants <3 months old to 12 cm in children
>12 years of age.
PORTAL VEIN - CORRECT ANSWERS Diameter: May be helpful in determining presence of
portal hypertension
Mean PV measurement: 8.5 mm in children <10 years of age; 10 mm in patients 10 to 20 years
old.
