Page 371 - Abstract Book KONIKA 18

Pediatric Imaging

P-PI-003
The Importance of Ultrasound Imaging in the Diagnosis of Abdominal
Tuberculosis: A Case Report

1
Arina Kartika , Resita Sehati , Evita Karianni Bermanshah 2
2
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
2
1
Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Abdominal tuberculosis contributes five percent of all tuberculosis cases with a 50% of mortality
rate in untreated abdominal tuberculosis cases. Nonspecific features of abdominal tuberculosis result in
the difficulties of establishing a diagnosis. Ultrasound is a readily available, noninvasive, and flexible, and
cross-sectional modality for imaging the abdomen and pelvis, and offer the advantage of examining the range
of abdominal involvements in a single examination. Objective To describe the importance of ultrasound
imaging in the diagnosis of abdominal tuberculosis. Case A 10-year-old girl was admitted to our hospital
for diarrhoea, abdominal discomfort, and vomiting for one month, and abdominal distention for two weeks.
She also complained of coughing and masses in the retroauricula and cervical region for one month. Her
grandmother was diagnosed with tuberculosis. Diagnostics showed positive tuberculin test and the rapid
molecular test was detected Mycobacterium tuberculosis. The chest X-ray presented paratracheal and hilus
lymphadenopathies. Cervical ultrasound showed bilateral multiple lymphadenopathies. The abdominal
ultrasound found multiple lymphadenopathies in paraaortic and mesenteries, with 0,4-2,1 cm in diameters,
and ascites. In examining abdominal tuberculosis, abdominal ultrasound was interpreted for: lymph node
involvement: site and characteristics; intestinal involvement: bowel wall thickening and atypical target
configuration; peritoneal involvement: ascites and peritoneal or omental thickening; the presence of abdominal
abscesses and visceral involvement: homogeneous organomegaly, focal lesion, or calcified foci. Conclusion
Ultrasound is a useful modality to help establish the diagnosis in clinically suspected abdominal tuberculosis.
This examination can prevent unnecessary surgical intervention.
Keywords: abdominal tuberculosis, ultrasound examination

P-PI-004
Ventriculitis in Neonates: Recognition by Cranial Sonography

Pebriansyah , Resita Sehati , Naela Fadhila , Evita Karianni 2
1
2
2
Department of Child Health and Pediatric Imaging Division, Department of Child Health ,
1
2
Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Ventriculitis is the most common complication of neonatal meningitis, occurring up to 20%
of all cases. There is no reliable clinical signs of ventriculitis. It mostly suspected if there is no clinical and
bacteriological improvement to appropriate antibiotic. Cranial sonography, which can be performed bedside
could help to demonstrate findings suggestive ventriculitis. Objective To demonstrate a case of neonatal
ventriculitis found by cranial sonography. Case A-20 days old-baby girl was referred with a chief complaint
of lethargic and dehydration one day prior to admission. No history of fever or vomiting. She was born
at 37 weeks by C-section due to premature rupture of membrane. Fetomaternal ultrasound at 32 weeks of
gestation found abnormalities in the brain, cisterna magna, lateral ventricles and choroid plexus, however
no further evaluation because no symptoms developed. She was lethargic but sucking reflex and oral intake
remains normal. No bulging nor sunken fontanelle but seizures presented on fifth day of hospitalizations.
Cranial sonography found ventriculomegaly suspected for hydrocephalus due to intracranial infection. Due
to repeated seizures, cranial sonography was repeated and found ventriculomegaly with internal echo and
septa suspected ventriculitis and decreased echogenicity in the brain parenchymal suspected leukomalacia.
Conclusion Cranial sonography plays an important role as initial evaluation of neonates with intracranial
infection and monitoring for its complications. Intraventricular debris and stranding, and an irregular and
echogenic ependyma are highly suggestive findings associated with ventriculitis. Intrauterine intracranial
abnormalities finding should be evaluated and confirmed postnatal with cranial sonography as soon as possible.
Keywords: ventriculitis, neonates, cranial sonography

KONIKA XVIII Abstract Book 323