Page 373 - Abstract Book KONIKA 18

Pediatric Imaging

P-PI-007
Abdominal Ultrasound as a Screening Tool
for Diagnosis of Necrotizing Enterocolitis

1
Radhian Amandito , Resita Sehati , Evita Karianni Bermanshah 2
2
2
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
1
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Necrotizing enterocolitis (NEC) is an inflammation leading to tissue injury in the gut in neonates.
It is a common and devastating intestinal disease and is a major source of morbidity and mortality. Abdominal
radiograph (AXR) remains the first-line modality in imaging investigations in NEC due to use of modified
Bell’s, however early diagnosis is difficult. Abdominal ultrasound (AUS) is superior to AXR due to its feature
of evaluating the gastrointestinal tract in detail; dilatation and elongation of intestinal wall, pneumatosis
intestinalis, portal vein gas, intestinal peristaltic movement, blood flow of the intestine, and perforation.
Objective To describe a case of necrotizing enterocolitis in a neonate diagnosed with abdominal ultrasound.
Case A 32 weeks preterm baby was born from a mother with placenta acreta and received active resuscitation
using CPAP. The baby was born by C-section with birth weight of 2795 grams and birth length was 44 cm.
On the 10th day baby had profuse vomiting, feces on tube, thrombocytopenia, and unstable hemodynamics
requiring inotropes and stopped enteral feeding. Based on AXR findings of intestinal wall dilatation and
elongation, pneumatosis intestinal, the patient was diagnosed as NEC grade 2. In the subsequent AUS, in
addition to the same findings, portal vein gas was also found. Conclusion AUS can be used as a screening
tool for evaluation of NEC. It can be used for repeated evaluation, no risk of radiation, can be done bedside,
and can visualize in more detail. AUS should become a part of standard screening of NEC in neonates.
Keywords: abdominal radiograph; abdominal ultrasound; NEC; portal vein gas

P-PI-008
The Role of Ultrasonography in Diagnosis of Tuberous Sclerosis Complex:
A Case Report

Andhika Mangala Putra , Naela Fadhila , Haryanti Fauzia Wulandari 2
1
2
1
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
2
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Bacground Tuberous scleoris complex (TSC) is an autosomal genetic disorder characterized by the growth
of numerous benign tumors in multiple organs including kidneys, heart, liver, eyes, lung and skin. Diagnosis
is made by genetic testing or fulfilling a diagnostic criteria. Due to the wide range of clinical presentation,
satisfying a diagnostic criteria is likely to require multiple radiographic modalities. Prudent abdominal
ultrasonography use may aid diagnosis in detecting abdominal hamartomas or angiolipomas, which on its
own satisfy a possible diagnosis criteria. Objective To demonstrate the role of abdominal ultrasonography
in the diagnosis of TSC. Case We present a case of a 17-year-old boy with previous history of abdominal
pain and multiple skin tumors. Multiple skin lesions in form of hypomelanic macules and tumors had been
present since the age of 6-months, and while he had lived most of his life relatively event-free, he has had
several episodes of abdominal pain in the past. Abdominal ultrasonography reveals multiple, hyperechoic,
vasculature lesions consistent with angiomyolipomas in kidneys, which are also found numerously in the
liver. These two findings alone are sufficient to satisfy the diagnostic criteria of TSC, which is further proven
with similar findings during brain-CT and funduscopic examinations. These findings negate the need of
genetic testing in this patient. Conclusion Abdominal ultrasonography may be useful as cheaper and readiliy
available initial diagnostic tool in diagnosis of TSC.
Keywords: tuberous sclerosis complex; diagnosis; abdominal ultrasonography

KONIKA XVIII Abstract Book 325