How to prepare a child for an abdominal ultrasound and how it is done. Why is an abdominal ultrasound performed on a child? Sizes of abdominal organs in children table

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The presence of liver problems can be determined using conventional ultrasound diagnostics. This study allows you to assess the nature of the disease, obtain information about its course, and also prescribe and adjust treatment.

Every doctor specializing in ultrasound knows what you need to pay attention to first. So, the diagnostician evaluates the density and structure of the organ, and checks for pathological inclusions. In addition, be sure to look at the size of the liver on an ultrasound. The norm for adults is established for each of its lobes. Its oblique transverse size is also assessed. During the study, the doctor looks at the condition of the bile ducts and large vessels passing inside the liver.

Such an examination allows you to clarify the diagnosis if several different diseases are suspected. And the established norm for liver size by ultrasound makes it possible to determine the presence or absence of pathological changes in this organ or deviations from its physiological development at different ages in children.

Indicative figures

Specialists know what data to focus on when examining and making a diagnosis. But if you want to find out for yourself whether you have problems, then you need to know the normal size of the liver by ultrasound. It is also important to understand where this organ is located.

The lower edge of the right lobe is located in the area of ​​the right costal arch. But in the presence of inflammatory diseases of the lungs and lower respiratory tract, it may shift slightly downward. But after resection of the lungs, with flatulence or tumors in the kidneys, it can rise.

In order to assess whether everything is in order with this organ, you need to know what the norm is for an ultrasound of the liver, what are the normal liver indicators. It should be of a homogeneous structure, without compactions, large veins should be easily visualized. Its contours should be clear and even. The gallbladder and ducts should also be visible. The inferior vena cava should be visualized along its entire length; its diameter can be from 9 to 15 mm. But the intrahepatic ducts should normally be difficult to trace.

Normal sizes

In addition to assessing the structure and location of the largest gland in the body, it is important to determine its other parameters. Thus, the normal size of the liver according to ultrasound should be as follows:

- left lobe - 6-8 cm;

- diameter - from 20 cm, an increase to 22.5 cm is permissible;

- right lobe - up to 12.5 cm;

— organ width (measurement from right to left) 23-27 cm;

- length (from the posterior blunt edge to the anterior sharp) varies from 14 to 20 cm.

The doctor should also evaluate the diameter of the hepatic common duct: normally it is 3-5 mm.

The doctor must know not only the norms for liver ultrasound. In addition, the gallbladder is also assessed. Its length in an adult is 7-10 cm, width 3-5, and diameter - 3-3.5 cm. The diameter of the bile duct should be 6-8 mm, the thickness of the walls of the organ - up to 4 mm, and the internal diameter of the lobar bile ducts – up to 3 mm. Normally there should be no formations in it.

Diagnosis in children

You can also assess the health of a child’s liver using ultrasound. It is important to understand that the size of this organ directly depends on the age of the child. So, the right lobe in babies under one year old should be 60 mm, it increases annually by 6 mm. At 15 years old, its size is 10 cm, and at 18 – about 12 cm. The right lobe in children under one year old should be 32-40 mm, it grows by 2 mm every year. At 15-18 years old, the size of this area should be about 5 cm. You should not try to diagnose the baby, even if you know what the normal size of the liver should be according to ultrasound. The protocol must be deciphered by a doctor. He will evaluate all indicators together and, if there are deviations, prescribe appropriate treatment.

It is also important to know that, regardless of age, it should be of a homogeneous structure and interrupted only by the portal vein and its branches. The bile ducts should also be visualized normally.

Conducting a survey

If you want the diagnosis to be performed as accurately as possible, then you need to prepare for an ultrasound. It is advisable to adhere to a certain diet for three days prior to the study. It is better to exclude high-calorie dishes and foods that cause increased gas formation. If you are overweight, have long-term constipation, or are bloated, it is better to do an enema before an ultrasound.

It is also advisable to drink adsorbent before diagnosis. This could be smecta, activated carbon or chamomile infusion.

The examination is usually carried out on an empty stomach. It is advisable not to eat for at least 8 hours before the ultrasound. If you feel thirsty, you are allowed to drink ordinary clean water.

To carry out the diagnosis, the patient must lie on his back. The doctor applies a special gel to the area of ​​the right hypochondrium and moves the device’s sensor over it. The procedure is absolutely painless. Children can be examined not only in the supine position, but also on the right or left side; sometimes the doctor asks the child to be seated for better visualization of the picture.

Indications for examination

There are a number of problems for which liver ultrasound is one of the mandatory examinations. It is necessary to carry out such a diagnosis if you or your child:

- a jaundiced coloration of the whites of the eyes and skin appeared;

- pain occurs in the area of ​​the right hypochondrium;

— the doctor suspects the presence of tumors in the liver;

— deviations in blood tests indicating pathology of the specified organ;

— there was an injury, and possible damage to the abdominal organs.

It is also recommended to periodically examine the liver if you are taking certain medications or if you abuse alcohol, or if you have chronic problems with this organ, the gallbladder or the pancreas.

If you know what the normal size of the liver should be according to ultrasound, you can even understand for yourself what is written in the examination report.

Possible problems

Any deviations from the norm are the reason that the doctor can make a specific diagnosis depending on the condition of the organ being examined. By performing an ultrasound, you can determine helminthic infestation (giardiasis in the liver), fatty degeneration of the gland, and see tumors and cysts. Also, with the help of this examination, diagnoses such as cirrhosis and hepatitis can be established. Each of these problems causes certain characteristic changes in the organ.

Diagnosis of diseases

With hepatitis, the liver begins to display waves worse; on the screen it looks quite dark. In addition, the disease is characterized by the fact that the edges of the organ are rounded, one or both of its lobes increase in size. Its structure becomes heterogeneous, and dilated portal and splenic veins are also visualized.

For example, knowing what the normal size of the liver should be according to ultrasound, you can establish a diagnosis such as cirrhosis. With this disease, the left lobe or the entire organ as a whole enlarges. In the later stages, on the contrary, it decreases due to the fact that cells begin to die. In addition, the density of tissues increases, their structure is heterogeneous. An ultrasound shows that the liver looks like a mosaic. This picture appears due to the presence of areas where tissues are restored. The edges of the liver become not smooth, but lumpy, and the diameter of the portal vein increases.

The helminthic infestation caused by Giardia is indicated by dark spots on the liver - these are places where worms are concentrated, and light areas are calcifications that appear in the later stages of the disease.

Tumors appear as dark (hypoechoic) or light (hyperechoic) spots. Also, with malignant formations, a dark rim is visible around them. Also, with tumors, the gallbladder is displaced and the lymph nodes become enlarged.

With fatty degeneration of the liver, increased echogenicity is noted, the picture on the ultrasound machine monitor is light, and the structure of the organ is mottled. There is also an increase in the size of the organ, blurred contours, and rounded edges.

The liver is a huge gland, without which almost no process in the body can occur. For this reason, the condition of the organ is of vital importance. As soon as any pathological process begins to develop in it, the size of the liver also changes. At the initial stages, such changes can only be traced with the help of special diagnostic methods, and when the pathology reaches a more serious stage, the changes are visualized.

Liver size: normal

First, let's figure out together what the normal size of an organ should be. In its natural state, the lower edge of the right lobe of the liver is at the level of the right costal arch, protruding up to 6 cm along the midline, and 1-2 cm along the midclavicular line. Even if the organ is not enlarged, some prolapse is allowed. It is observed in bronchial asthma, massive pleurisy or asthmatic bronchitis.

If lung resection or flatulence is noted, the liver may be located high. Normally, the angle of the lower edge of the left lobe is about 30 degrees (maximum - up to 45 degrees), and the right lobe is 75 degrees or more. Today, experts say that in healthy people, the vertical oblique size of the right part of the liver is within 15 cm, and the height (craniocaudal size) is 8.5-12.5 cm. But the height of the left hepatic lobe is up to 10 cm. Thickness the right lobe is about 11-12.5 cm, the left lobe is up to 8 cm.

During an echogram, you can count on the following liver sizes:

• Length in the transverse plane – 14 – 19 cm (average – 17 cm);
• The length of the right lobe is 11-15 cm (on average 13 cm).

This difference in rates is due to differences in data in the medical literature itself. The indicators differ against the background of the use of differential techniques. Also, the size of the liver is directly affected by the height, age, constitution of a person and the depth of inspiration at which the echogram was taken. For this reason, in situations where the study records borderline dimensions, the conclusion cannot be categorical. It indicates a digital value (usually the vertical size of one of the lobes of the organ).

The structure of the liver parenchyma is normally homogeneous, fine-grained, and low-intensity. It visualizes the vascular network and bile ducts. The size of the veins of the organ is also of great importance. Normally, the diameter of the portal vein, according to various sources, ranges from 8 to 14 mm, and its branches - up to 1 mm.

Liver vein size

Of course, the correct parameters of the organ itself are of enormous importance, but you also need to pay attention to the condition of the veins. Very often, specialists have to conduct a general analysis of the state of the portal system. To do this, you need to evaluate the splenic vein and mesenteric superior vein. The first is located behind the pancreas, located ventral to the large vessels. The splenic vein has a lumen of about 8-10 mm on inspiration, and on exhalation it decreases to 4-6 mm. The diameter of the mesenteric superior vein on inspiration is 8-11 mm, and on exhalation – 4-6 mm.

It is especially important to correctly analyze the diameter of each of the portal vessels during deep and relaxed inspiration. The veins of this gland consist of main trunks - left, right and middle, as well as small branches. All of them have a smooth internal contour. At a distance of 2 cm from the mouths, the diameter of such vessels ranges from 6 to 10 mm. The structure of the inferior vena cava is tubular in nature, its diameter changes during breathing and is 2-2.5 cm.

Organ sizes in children of different ages

The normal parameters of this huge gland in children are determined using numerous formulas, including volumetric ones. They should be used by professionals in specialized medical centers. The fact is that the size of the liver at different ages in children can vary. The right lobe may be located up to the lower pole of the kidney; it can be lowered even lower in the presence of the Riedel lobe. In one-year-old babies, the left lobe most often extends beyond the midline during transverse scanning, and in older children - to the aorta.

With hepatomegaly, the left lobe of the organ in children reaches the spleen, slightly displacing it downwards. Moreover, the organ itself is divided into three lobes: right, left, caudate. Each lobe has its own segments. The right lobe of the liver has posterior and anterior segments. The border between them is the right hepatic vein. The left lobe is divided by the left hepatic vein into lateral and medial segments. Each of these areas has a separate blood circulation.

The size of the liver in young children can vary under the influence of a large number of factors. The table will help you get acquainted with the average statistical indicators.

About ultrasound of the liver for a child

The liver is one of the most important organs in a child's body. The liver neutralizes and removes almost all toxic substances, synthesizes biologically active substances and controls energy balance. To obtain all the necessary data or obtain reliable information about its condition and operation, it is necessary to do an ultrasound examination.

Ultrasound of the liver allows you to accurately determine the structure of the organ, diameter, size of existing changes, as well as analyze all deviations from the norm. Ultrasound of the liver is the safest, painless and informative research method. Most often, this is the only way to diagnose a disease.

Indications for liver ultrasound in children:

Preparation for ultrasound examination of the liver in children:

• Follow a certain diet for three days before the procedure;
• Do not eat foods rich in fiber;
• If you are overweight, you should give your child an enema the evening before the procedure;
• For two days, exclude from the diet all foods that contribute to gas formation, as well as exclude high-calorie foods;
• The procedure must be carried out on an empty stomach;
• Do not eat food 6 hours before the procedure;
• When thirsty, give only clean water to drink.

The liver ultrasound procedure is as follows:: the child lies on his back, the doctor applies a special gel to the area being examined, which helps the sensor slide over the skin and begins to carry out diagnostics.

If necessary, an ultrasound scan of the child’s liver can be performed not only on the back, but also on the right or left side, or in a sitting position.

Norms of liver ultrasound in children

When performing an ultrasound of the liver in children, the doctor pays special attention to the structure and homogeneity of the liver, pays attention to large vessels, small branches and bile ducts. The normal liver ultrasound for children is:

• Parenchyma of a homogeneous structure, which is interrupted by the portal vein with branches;
• All veins are clearly visible;
• The bile ducts are clearly visible.

• 1 year - 60 mm, each subsequent year + 6 mm;
• 15 years - 100 mm;
• 18 years - 120 mm.

• 1 year - 33-40 mm, each subsequent year 2 mm;
• 15 years - 50 + 1.5 mm;
• 18 years old - 50 + 1.5 mm.

Interpretation of ultrasound of the liver in a child

After receiving all the readings, the doctor begins interpreting the ultrasound of the child’s liver.. Ultrasound is the most important method for examining children who have diseases or suspicions of their presence in the digestive organs. Ultrasound for children is the most informative diagnostic method, which is widely used in outpatient practice, in specialized gastroenterological clinics and has no restrictions on its use.

After deciphering the ultrasound readings, it is possible to identify a large number of hidden diseases of the digestive system (ultrasound of the abdominal cavity is used for this) or any other diseases of the child’s body. The interpretation of the ultrasound and the doctor’s testimony help formulate the exact treatment tactics. This allows you to begin treating existing pathologies as soon as possible.

Get an ultrasound of the liver in our center

The equipment in our “Cradle of Health” center for liver ultrasound is constantly being improved, this allows us to make this method very informative and completely safe for a small patient. The liver is a very important organ that is responsible for the entire digestive system of the body. Keeping your liver healthy is key to your baby's health. and a guaranteed successful future life. If your child has indications for an ultrasound examination, contact our Cradle of Health center and experienced specialists will help you.

We have a large staff of highly qualified workers who are fluent in the technique of performing ultrasound procedures. After receiving the conclusion, our doctors will draw up a comprehensive treatment plan for existing diseases and give recommendations for changing the baby’s lifestyle. It is important to remember that the human digestive system is one of the most important systems of the body. Therefore, you should not postpone a visit to a consulting pediatrician (pediatrician) and the liver ultrasound procedure itself.

Advantages of performing an ultrasound of a child's liver in our center “Cradle of Health”:

1. The procedure is performed by highly qualified doctors with extensive practical experience;
2. The procedure is carried out using modern equipment;
3. The procedure has no contraindications;
4. The procedure is easy to perform, which is a huge plus for a small child;
5. The procedure provides research data over time;
6. The procedure is completely safe for the baby.

In our center you can easily and quickly undergo an ultrasound of a child’s liver, an ultrasound of a child’s head, with us you will receive high-quality ultrasound diagnostics and consultation with an experienced pediatrician.

Ultrasound diagnostic doctors at our center

Kazantseva Marina Anatolyevna

Functional diagnostics doctor. Candidate of Medical Sciences. Assistant professor.

Graduated from Kemerovo State Medical Institute with a degree in pediatrics. Has valid certificates in ultrasound diagnostics and functional diagnostics.

Having extensive experience and the highest qualifications, he never ceases to improve his professional knowledge.

Menzelintseva Svetlana Konstantinovna

Ultrasound diagnostics doctor. Total work experience 24 years

She graduated from the Karaganda State Medical Institute in 1992 with a degree in pediatrics.

She is a highly qualified specialist, attentive, quickly finds an approach to children, and enjoys great respect among her colleagues.

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The ultrasound research method is very informative. An abdominal ultrasound of a child includes examination of the liver, spleen, pancreas and gallbladder. All of these organs are involved in the digestion process, so it is necessary to identify possible problems associated with digestion as early as possible and help the child cope with them as quickly as possible.

Ultrasound waves reflecting from organs make it possible to provide accurate information about the size and density of organs, structure, and wall thickness. Ultrasound diagnostics has been used in pediatric practice for more than 20 years and is a safe examination even for children.

Indications for ultrasound of the abdominal cavity.

A referral for an ultrasound examination of the abdominal organs of a child is given by a pediatrician or gastroenterologist. Infants undergo an ultrasound at 1-1.5 months to identify any pathology or make sure that everything is in order.

If your child is bothered by pain or discomfort in the epigastric region, in the upper abdomen, or a feeling of heaviness in the right or left hypochondrium.

Worrying pain in the abdomen, a feeling of bitterness in the mouth, yellowness of the sclera of the eyes. Having such complaints, it is necessary to undergo an ultrasound examination of the abdominal organs.

Preparing a child for an ultrasound of the abdominal organs.

An ultrasound scan of the abdominal cavity requires preparation in order to reduce gas formation, which can distort the picture of the examination.

To do this, you need to exclude: legumes, brown bread, milk, apples, soda, sweets (cakes, pastries). You can also take enzymes (Festal, Mezim-Forte, Microzim, Creon.) 2-3 days before the ultrasound. The examination is performed on an empty stomach 8-10 hours after eating.

For infants, everything is much simpler; the procedure is carried out immediately before the next feeding. Breast milk is digested in 3 hours, formula in 3.5 hours, fruit puree and vegetables take much longer to digest, so it is not recommended to give them.

Until the digestion process is completed in the stomach, the organs are in an altered state, for example, the pancreas is enlarged due to blood flow, and the gallbladder is in a contracted state, which prevents the doctor from correctly assessing them and determining their size.

How it is carried out.

The child must be dressed so that the upper abdomen is easy to open; during the examination, the baby will lie on the couch, and the doctor will apply a special gel to the sensor and move it slowly over the abdomen.

After the examination, the gel is easily removed without leaving any traces. During the examination, the doctor will ask you to turn on your side or hold your breath. All this is necessary to obtain a clearer image on the monitor screen.

Ultrasound of the liver in children.

The liver is one of the most important organs in a child’s body. The function of the liver is to neutralize and remove almost all toxic substances, to control energy balance (the liver pumps blood about 350 times per day).

What can be determined by ultrasound of a child’s liver? The structure is homogeneous or heterogeneous, attention is paid to the diameter of large vessels, size, existing changes (granularity, cysts, fatty degeneration). This method is, first of all, safe, painless and informative.

Liver pathology in children.

Causes of liver pathology in children.

• Inflammatory processes, intoxication,
• Metabolic disorders, unhealthy diet.
• Benign enlargement of liver cells (excess vitamin A), sepsis.
• Congenital fibrosis, multicystic disease, biliary cirrhosis.
• Leukemia, malignant tumors, metastases.
• Impaired outflow of blood and bile, obstruction of the bile ducts, venous stenosis or thrombosis, Wilson's disease, cirrhosis of the liver .

Liver sizes in children according to ultrasound:

Right lobe–1 year –60 mm, each subsequent year +6 cm, 15 years –100 mm, 18 years –120 mm.

Left lobe–1 year –33-40 mm, each subsequent year +2 mm, 15 years –50 mm.

Normally, the liver parenchyma should be homogeneous.

Enlarged liver (Hepatomegaly) in newborns and children under 7 years of age, age-related hepatomegaly is observed, in which the lower border protrudes from under the edge by 1 - 2 centimeters. If hepatomegaly is diagnosed in older children, this is a pathology.

Heterogeneous liver structure

Diffuse changes in the liver parenchyma give a picture of a heterogeneous structure. A normal liver has a homogeneous structure, there is no compaction or tissue deformation. A diffuse changes liver tissue occurs when the structure of the organ is disrupted while its function is preserved or is accompanied by severe liver failure with frequent bleeding and increasing intoxication.

The causes are various diseases (hepatitis, lipomatosis) and are characterized by changes in the structure of the entire tissue; there is also a so-called general disease associated with metabolic disorders.

Liver granularity.

Found on liver ultrasound in children grain, may also indicate some kind of pathology.

Fine-grained liver structure determined in a healthy child.

Coarse grain develops during pathological processes (hepatitis, toxic damage, diabetes mellitus) there is a proliferation of connective tissue structures, and it also happens when there is swelling of the intercellular space with such a pathology, the granularity increases. When the causative factors are eliminated, the structure can be restored.

Condition of blood vessels.

During an ultrasound of the liver in children, the condition of large vessels plays an important role, namely, the portal vein is assessed; its normal diameter ranges from 8 to 12 millimeters; if it is more than 14 millimeters, this indicates the onset of portal hypertension. This occurs in infectious and viral diseases. The vascular network of biliary patency is also visualized.

Fatty degeneration (hepatosis).

Fat is deposited in the liver lobules; there are several stages of fatty degeneration.

Initial stage - the size of the liver is slightly increased, the edge is slightly rounded, and islands of granularity appear in the liver tissue.

In the second stage, the liver is enlarged, diffuse changes in the organ tissue appear, tissue compaction appears, and small focal changes appear.

In the third stage, the structure of the liver is significantly densified (echogenicity is increased) and the vessels are poorly visible.

The fourth stage of cirrhosis - there is a change in size, uneven contours, rounded edges, poor elasticity, an increase in the diameter of the veins.

Liver cyst in a child.

Finding a cyst during an ultrasound of a child’s abdominal organs is a fairly common occurrence, especially in newborns. It is quite rare in older children.

The liver cyst itself in a child is a benign formation that looks like a cavity filled with liquid; the diameter can reach 230 millimeters. Inside there is a colorless liquid, but quite often it can have a brown or yellowish-green tint.

Cysts develop during the intrauterine formation of the fetus, so they are common in newborns and, as a rule, they resolve on their own by the first year of life or even before the baby is born.

Most often they have a round shape and are found in the lower part of the liver, in the right lobe or on the surface of the organ itself. A liver cyst in a child is asymptomatic, although ruptures with peritonitis are possible. Cysts can be congenital or acquired. Acquired rather rare phenomenon; their causes are:

• Injuries to the liver and other organs
• Surgical interventions
• Liver abscess

A newborn with a liver cyst may have:

• Lack of weight.
• Nausea, vomiting.
• Bloating.
• Poor appetite.
• Abdominal asymmetry

Cysts up to 3 centimeters found during liver ultrasound in children cannot be operated on; such neoplasms are usually treated with medications and special diets. Polycystic liver disease requires constant monitoring by a pediatrician. When the cyst reaches an impressive size, it is removed surgically; in the severe stage of polycystic disease, the newborn may need a liver transplant.

Ultrasound of the gallbladder in a child.

The gallbladder is a reservoir for the accumulation of bile. It has the shape of a “drop” or “pear”, and is filled with olive-colored bile; the gallbladder is located at the bottom of the liver. Bile takes part in digestion, namely in the digestion of fats, stimulates the intestines to work well, serves for the so-called “hygiene” of the intestines, both to suppress putrefactive processes and to fight protozoa and worms. Therefore, any dysfunction of this organ disrupts the digestive processes. As you know, ultrasound is the most effective and safe examination method. It is necessary to do an ultrasound of the child’s gallbladder if:

• Pain in the right hypochondrium.
• Suspicion of inflammation of the gallbladder (cholecystitis).
• Abdominal injuries.
• Presence of bitterness in the mouth.
• Feeling of constant nausea or nausea with vomiting, especially bile.

The preparation is the same as for an ultrasound of the abdominal cavity of a child: foods that cause gas formation (brown bread, peas, beans, cabbage, soda, cakes), spicy, salty, and smoked foods are excluded. For better visibility on the device screen, you can take enzymes (Festal, Mezim-Forte, Creon) and carminatives (Espumizan, Dill water).

The procedure is carried out on an empty stomach, dinner the day before no later than 19:00, which should be light; In the morning, before the examination, you should not drink water. As for infants, it is better for them to be examined before the next feeding. And for older children, you can take food with you. If there is a suspicion of the presence of stones or acute pain appears, in this case no special preparation is carried out.

A diagnostician conducting an ultrasound examination of a child’s gallbladder evaluates the shape, wall thickness, size and volume of the gallbladder. The size of the gallbladder in children depends on its age:

From 2-5 years, length 30-50 mm, width 13-24 mm;

6-8 years, length 45-75, width 10-20;

9-11 years, length 35-64, width 11-30;

12-16 years, length 40-80, width 12-27;

If the gallbladder has a teardrop shape, the walls are not enlarged, there is no stagnation of bile, there are no kinks, sand, and especially stones, then this is a normal variant.

• The diagnosis of Discension can be made if there are such deviations in the bladder: there is stagnation of bile, that is, the motility (work) of the gallbladder is disrupted and the tone of the bladder itself and the bile ducts is reduced, the neck of the gallbladder is bent, the walls of the bladder are thickened.
• The diagnosis of Cholelithiasis (Cholelithiasis) is made when there are stones in the cavity and bile ducts and a change in the position of the body of the organ; they move noticeably inside the gallbladder and give an acoustic shadow, in this case the boundaries of the organ become uneven, and thickening of the walls is diagnosed.
• Diagnosis Polyps, they are on the walls of the organ and have a round shape; do not give an acoustic shadow and are detected by chance, since they do not manifest themselves in any way.

Ultrasound of villageszenki in children.

The spleen is part of the circulatory system; the main function of the spleen is to fight microorganisms that have penetrated into the body, which worsen the general well-being of the child. Serves as a place for the accumulation of unnecessary blood cells, stores blood elements, and takes part in the integration of proteins.

How to prepare a child for an ultrasound of the spleen?

Preparation, as for an ultrasound of the abdominal organs of a child, the examination is carried out on an empty stomach (with a break of about 7-8 hours), before the ultrasound you should not drink water for 3 hours, do not take foods that increase gas formation for 3 days.

The ultrasound examination of the spleen in children is painless and takes about 5 minutes. The examination is carried out while lying on your back, the doctor moves the sensor in the area of ​​the left hypochondrium, then lying on your side. After the examination, the diagnostician issues a conclusion with which it is necessary to contact the pediatrician about further treatment or further diagnostics and identifying the cause of its increase.

Norms of the spleen in children according to ultrasound.

Age Length (mm) Width (mm)

Newborn 38 40

1-3 years 62 30

3-5 years 76 42

5-7 years 88 43

7-10 years 92 46

10-15 years 102 51

If, according to ultrasound of the spleen in children, the size differs from the norm, then this indicates its enlargement.

The spleen is an important organ; it is a source of immune cells-lymphocytes. Human immunity depends on the spleen. More often, an enlarged spleen is caused by infections (hepatitis, infectious mononucleosis, typhoid fever), oncology, and a disease associated with blood disease with liver damage. It can also be increased with anemia and rickets, and even in newborns with congenital cytomegalovirus infection.

Ultrasound of the pancreas in children.

It is necessary to undergo this examination if the child has complaints about:

• Pain and discomfort in the left side with radiation to the left shoulder, back area;
• Abnormal stool, indigestible food in the child’s stool;
• Sudden weight loss;
• Intense thirst;
• Suspicion of acute or chronic pancreatitis;
• Heaviness, bloating after eating;
• Changes in blood and urine tests;

Ultrasound of the pancreas in children is performed in the supine position. The doctor applies a special gel to the abdomen, which is used to make the sensor glide better. Since the pancreas is located deep, to better view it, the child will be asked to take a deep breath and hold his breath; Also, if necessary, the examination may be carried out on the right side or you may be asked to stand on your feet. The duration of the procedure itself is within 5-10 minutes. Attention is also drawn to the contours of the organ; normally they are clear and even.

Dimensions of the pancreas according to ultrasound in a child.

Age Head Body Tail

Up to 1 month 11 7 11

1 month - 1 year. 16 9 13

1-5 years 18 11 19

6-10 years 17 11 19

11-18 years old 21 12 21

If ultrasound echogenicity is increased, this indicates chronic pancreatitis or a tumor, as well as fatty tissue degeneration.

If the echogenicity is reduced, then this indicates an acute form of pancreatitis.

If diffuse changes are detected during an ultrasound of the pancreas in children, this indicates that changes have occurred in the entire organ, and not in a separate part of it, which serves as an additional signal to the doctor for further examination of the child. This can occur due to circulatory disorders of the organ, liver disease, gallbladder, bile ducts.

If there is an increase in tissue density, increased echogenicity, but the gland remains normal in size or has a slight decrease in size, then most likely you have suffered inflammation in the gland or a metabolic disorder has occurred (when normal tissue is replaced by connective tissue).

The kidneys are an organ of the urinary system, which is a kind of filter that rids the body of harmful substances. They are responsible for regulating fluid balance and also influence homeostasis.

And if a child begins to complain of pain in the lumbar region or problems with urination, this may indicate the presence of a pathology of the urinary system.

To confirm or refute the presence of a problem, an ultrasound examination of the kidneys is prescribed. The procedure is absolutely safe and allows you to see a complete picture of the condition of the organ.

When the kidney ultrasound has been done, the doctor interprets the results of the study. But it is possible to do this yourself, relying on a table with standards, which indicates the normal size of the kidneys according to ultrasound in children.

When and to whom is it prescribed?

Kidney ultrasound is prescribed at any age if indicators are available. Possible indications for testing in newborns are:

• difficult pregnancy, childbirth;
• the presence of congenital diseases of the genitourinary system in parents;
• detection of stones in urine;
• excess of normal blood levels;
• the presence of deviations in the development of external organs;
• dysbacteriosis;
• increased blood pressure;
• swelling of the limbs.

Kidney ultrasound is prescribed at any age if indicators are available

Indications for ultrasound diagnostics in children over 1 year of age are the presence of the following symptoms:

• pain in the lumbar region;
• change in urine color, hematuria;
• headaches, migraines;
• discomfort after injuries to the lower back, abdomen;
• causeless high body temperature;
• increased concentration of salt in urine;
• neoplasms diagnosed by touch.

It is necessary to conduct a study if there is a suspicion of kidney inflammation, disorders of the endocrinological system, or diseases of the cardiovascular system have been detected.

An ultrasound should be done when preparing the baby for surgery.

How to prepare a child?

For the results of the study to be accurate, the baby must be prepared for the procedure. First of all, he needs to explain that an ultrasound is a painless procedure that does not cause any discomfort, and that there is no need to be afraid.

The child must understand that during the examination you need to listen to the doctor and not be mischievous. 8 hours before the procedure, the child must refuse to eat, and 3 days before the session it is necessary to follow a special diet aimed at reducing the formation of gases in the intestines, improving the visibility of the cavity.

Ultrasound is a painless procedure that does not cause any discomfort to the child.

You need to adhere to the principles of the diet:

• stop consuming legumes, cabbage, dairy products and carbonated drinks;
• limit the consumption of sweet, fried, fatty foods;
• after meals, drink activated carbon at the rate of 1 tablet per 10 kg of weight;
• If you have flatulence, you need to take an Espumisan tablet 2-3 hours before the session.

To ensure that organs are clearly visible during an ultrasound, you must come to the procedure with a full bladder. To do this, half an hour before the start of the study, you should drink a certain amount of water equal to the volume of your bladder.

For children under 2 years old, the amount of liquid drunk should be no more than 100 ml, for children 2-7 years old - 200 ml, at the age of 7-11 years old you need to drink 400 ml, and at an older age - at least 0.5 liters of water. Before going to the hospital, it is recommended to purchase a diaper and wipes.

Rules for conducting a pediatric ultrasound

An ultrasound of the kidneys is performed by a sonologist in a specially equipped room, in the presence of parents. The child lies down on the couch, freeing the lower back and stomach from clothing. If the baby is a newborn, then during the study he is in the arms of his mother. Sometimes the procedure is performed in a standing position.

After the patient is positioned on the couch, the doctor applies a special gel to the area being examined, which is absolutely harmless and can be easily removed from the skin with a napkin.

The specialist then moves a sensor over the body, observing a three-dimensional image on the screen. For a better overview of the organ, the organ is examined while moving in different planes, for which the doctor may ask the child to turn around, stand up, or sit down. The baby must follow all the sonologist’s instructions. The duration of the procedure is 5-30 minutes.

At the end of the session, parents are given ultrasound results, which are interpreted by a pediatric urologist or nephrologist. If it is not possible to see a doctor as soon as possible, you can decipher the ultrasound results using the table of standards.

What does a kidney ultrasound show?

Ultrasound diagnostics of the kidneys in a child allows you to assess the number and size of organs, their location and shape, and shows the parameters, structure, and condition of the tissues. This study allows you to detect pathology of the kidneys and organs of the urinary system.

A doctor can decipher an ultrasound of the kidneys

During an ultrasound, the doctor pays attention to the following points:

• Number of kidneys. There will be 2 of them: on the right and on the left. Sometimes the position of the kidneys changes, as a result of which they may be located one under the other or descend into the pelvic area.
• Organ performance. Both kidneys must function equally.
• Form. A healthy organ has the shape of a bean grain. Due to abnormal development, the kidney can take the shape of the letter S or L, the appearance of a horseshoe. Sometimes the buds grow together.
• Mobility. In healthy kidneys, it is no more than 1.5 cm. If the organ descends or begins to wander, then mobility increases.
• Presence of stones, stagnation in the cavity. In a normal state, none of this should happen.

In addition, during an ultrasound, attention is paid to the size of the organ, the thickness of the walls, the condition of the structural tissues, as well as some other important parameters that make it possible to diagnose the presence of abnormalities.

Decoding and standards

A pediatric urologist or nephrologist interprets the results of kidney ultrasound in children, in strict accordance with the normal table. This table with standards includes features and possible deviations.

For each age, the norm varies. Ideally, the contours of the organ should be smooth, with a clearly visible fibrous capsule. The dimensions of the pelvis should not exceed 6 mm. The normal rate of renal blood flow is 50-150 cm/sec.

When identifying pathological conditions, the size of the kidneys is of great importance, which varies depending on the age and height of the child.

In a newborn baby, until he is 2 months old, the kidney size is 49 mm, and the renal pelvis is 6 mm. From the age of three months until the baby reaches 1 year of age, the organ increases by 13 mm and is 62 mm.

Until a child reaches 12 years of age, the size of the kidney increases by approximately 13 mm every 5 years. The weight of the organ in a newborn baby is 12 grams, by the age of 5 it is 54-56 grams, and by the age of 18 the weight of the organ is 120 grams.

The exact indicators of the length, width and thickness of the left and right kidneys can be determined using a special table, taking into account the height and age of the baby.

What diseases can be detected?

Based on the results of ultrasound diagnostics of the child’s kidneys, the presence of pathologies can be determined:

• pyelonephritis;
• urolithiasis disease;
• nephrosclerosis;
• hydronephrosis;
• nephroptosis;
• congenital anomalies;
• narrowing of the ureters;
• cystosis;
• glomerulonephritis;
• tumor neoplasms;
• acute cystitis;
• circulatory disorders;
• abscess.

Kidney ultrasound allows you to determine the presence of any structural changes in organs, inflammation or any other deviation from the norm.

You can make an approximate interpretation of the diagnostic results yourself, but an experienced specialist with knowledge of terminology can make an accurate diagnosis and prescribe treatment.

Ultrasound of the abdominal cavity is a completely safe diagnostic method for suspected gastrointestinal disorders in a child. The main organs examined are the liver, stomach, pancreas, spleen, gallbladder and intestines. To clarify the diagnosis, the doctor often examines the abdominal cavity in conjunction with the organs of the genitourinary system. Parents should prepare their child for the study by following a strict diet and temporarily restricting food intake.

Ultrasound of the abdominal organs is a safe research method that allows you to accurately diagnose and prescribe the correct treatment.

What organs are examined during an abdominal ultrasound?

Abdominal ultrasound is a diagnostic method that shows the health status of the main organs of the digestive tract and genitourinary system. Due to their size, these organs reflect sound waves well. This characteristic allows the doctor to accurately assess the condition of the organs being examined.

Abdominal ultrasound includes diagnostics:

• Liver. She is examined first of all to exclude hepatosis, cysts or tumors in the child.
• Spleens. The doctor determines its structure, location and size in order to exclude an inflammatory process or neoplasm.
• Pancreas. Diagnostics are carried out to determine the condition of its lobes.
• Esophagus and stomach. The specialist evaluates their performance based on external signs and the presence/absence of tumors.
• Gallbladder. The doctor determines the condition of its walls, and also confirms or excludes the presence of polyps or stones.
• Intestines. Only the large intestine is diagnosed.
• Kidneys and bladder. An ultrasound specialist evaluates their location and size to exclude an inflammatory process.

Indications for research in children

Ultrasound as a method of examining the abdominal organs is considered the most informative and safe, so it is performed even on infants. The main symptoms for which ultrasound diagnostics of the esophagus is indicated:

• increased flatulence;
• excessive and regular regurgitation after feeding;
• painful sensations in the abdominal area after eating;
• hypersalivation - excessive salivation;
• frequent pain under the right rib.

These signs can be manifestations of such serious diseases as hepatitis, inflammation of the stomach, pancreas, gall bladder, cyst or neoplasm in the abdominal organs. Any of these diagnoses can only be made after a comprehensive examination, which includes screening and laboratory tests.

Contraindications to the procedure

Parents should also notify the ultrasound specialist if the child is taking medications if the baby is undergoing medication treatment. An acute infectious disease is a direct contraindication to ultrasound. Also, parents should wait to make a diagnosis when the baby has a rash on the stomach. Infancy is not a contraindication, since this research method is absolutely safe even for a newborn.

Algorithm for preparing for abdominal ultrasound

Before diagnosis, caring mothers often read relevant articles and watch videos to be aware of how to properly prepare for a gastrointestinal ultrasound. To obtain an accurate result, parents should follow the following preparation algorithm:

• Infants should not eat for several hours (2-3) before the start of the study, and also limit fluid intake an hour before the ultrasound;
• children from 1 to 3 years old can be fed no later than 4 hours and given a drink an hour before diagnosis;
• Children over 3 years of age should have their last meal 6-8 hours before screening.

For breastfed newborns, the only requirement is a short-term restriction in food. All other preparatory activities are carried out by the mother; she is the one who fully prepares for the screening. Her main task is to review her diet and adhere to a strict diet. A nursing mother should stop eating foods that can cause flatulence in the baby.

A couple of days before the scheduled screening, the child is recommended to go on a light diet

Preparing a child over 1 year old requires eliminating the following foods a few days before an abdominal ultrasound:

• fresh vegetables and fruits;
• legumes;
• chocolate;
• cabbage;
• black bread;
• dairy and fermented milk products.

A couple of days before screening, children are usually given enterosorbents and carminatives, for example, Espumisan and Polysorb, especially if the baby is prone to increased gas production. Other medications should be stopped or a doctor should be consulted regarding the potential effect of the drug on the ultrasound result.

Examination of other internal organs also requires special preparation. So, for example, before an ultrasound examination of the kidneys or bladder, the child should be given the maximum possible amount of liquid 30-40 minutes before the start of the screening.

How is diagnosis carried out in children?

First of all, the baby should be properly set up for research - for example, invent an interesting story with his participation in the leading role. If the child behaves as calmly as possible during the procedure, the examination will take place as quickly as possible. The infant needs to take his favorite rattles. For an older child, you can grab your favorite treat.

Secondly, parents should take care of clothes in advance. The mother should dress the baby so that during screening she can easily empty his belly. The best option is a shirt and jacket with buttons or a zipper.

Parents must bring with them a diaper to cover the couch. During the examination, the baby lies on his back. Depending on which organs need to be checked, the ultrasound specialist will ask the patient to change position - lie on his side or on his stomach. Diagnosis is carried out using a special sensor, which the doctor moves across the stomach in the area of ​​the abdominal organs.

On average, this study takes from 10 to 25 minutes. At the end of the procedure, the doctor gives the parents a protocol indicating all the parameters and a conclusion.

Decoding the results: norms and pathologies

The research protocol, as a rule, contains a description of the main parameters of the abdominal organs - size, position and structure. This diagnostic method determines the presence of free fluid, as well as the condition of the retroperitoneal lymph nodes. Changes in these indicators indicate the development of the following pathological processes:

Cost of abdominal ultrasound

Today, an abdominal ultrasound can be performed on a child at any public and private medical center. Its cost is determined by the number of organs examined, as well as the level of the ultrasound machine. On average, the price of comprehensive diagnostics is 1,500-15,000 rubles. An ultrasound of other internal organs may cost parents less; for example, an ultrasound of a child’s stomach will cost only 300-1500 rubles.

Ultrasound diagnostics has become firmly established in the arsenal of modern healthcare. The widespread use of ultrasound in medicine has become possible thanks to the development of modern technology, and it is constantly being improved.

The use of such equipment is based on the use of ultrasound, which, reflected from tissues with different densities, is captured by a sensor and converted into a black and white image, which is assessed by the doctor on the monitor screen.

Ultrasound diagnostics is used in many medical specialties and provides invaluable data on the patient’s health status. Such a branch of medicine as pediatrics is no exception, when it is necessary to perform an ultrasound on a child.

A special feature of performing ultrasound for children is the variety of indicators, which depend on the age and weight of the child. The difficulty when conducting an ultrasound scan for children is the child’s fear and restless behavior when seeing a doctor and during the examination.

Indications for ultrasound of children

Pediatric ultrasound: indications for its performance can be divided into planned and emergency.

Emergency ultrasound examination is caused by acute conditions that require intensive care or surgical treatment, as well as assessment of the dynamics of treatment.

Routine ultrasound is usually performed at certain stages of a child’s development, as well as when he is diagnosed with a specific disease that requires dynamic monitoring and adjustment of appropriate therapy.

The main indication for ultrasound of a baby in the first year of life is the diagnosis of developmental defects. The importance of this lies in the fact that modern medicine can correct many defects, but this requires early diagnosis.

It is also worth noting that the child is constantly growing and gaining weight, so there are certain standards for ultrasound indicators in accordance with the age, weight and surface area of ​​the child’s body. Thanks to these standards, it is possible to determine the delay, normal or intensive development of the child’s body and find out the cause of the problem.

The process of examining a child is the same as examining an adult, the only caveat is that children cannot remain motionless for a long time, although this is a condition for a successful examination

Safety of this research method

Ultrasound examination of organs and systems in children of all ages is absolutely harmless and safe, since ultrasound is based on the use of vibrations of sound waves with a frequency of more than 20 thousand Hz. These waves are not perceived by the human ear and do not affect the patient’s well-being in any way.

Ultrasound is generated and captured by special crystals, sound waves are reflected from internal organs, and then the received information is processed by a computer and displayed on the monitor screen in the form of a black and white image. During the examination, the doctor moves a sensor in which crystals are placed over the area of ​​interest.

How to prepare

In some cases, special preparation is required to perform ultrasound examinations in children.

So, to perform an examination of the abdominal organs, it is first necessary to prepare the intestines in order to reduce the process of gas formation. To do this, you need to avoid eating foods such as bread, dairy products, apples, cabbage and legumes in the evening.

Ultrasound diagnostics are best performed in the morning on an empty stomach. In infants, an ultrasound is performed before the next feeding. Before examining the bladder and pelvic organs, it is necessary to fill the bladder.

It is very important to explain to young children that nothing bad will happen during the procedure. This is necessary so that the child behaves calmly and is not afraid of the examination, since for ultrasound diagnostics it is necessary to lie still. For emergency indications, ultrasound is performed without special preparation. In other cases, preparation for ultrasound examination is not required.

Signs of the most famous childhood pathologies

Indications for performing ultrasound diagnostics in children of all ages are acute conditions such as appendicitis, mesadenitis, acute intestinal obstruction, intestinal, renal and hepatic colic, etc.

Diagnosis of such diseases, thanks to ultrasound, helps determine the tactics of further treatment and resort to surgical treatment, if indicated. Acute appendicitis is characterized by enlargement of the mesenteric lymph nodes, which are located in a group.

This is how the picture shows appendicitis. Images of the disease in children are similar to those in adults

Since in children the layer of subcutaneous fatty tissue is not yet very developed, an inflamed appendix can often be visualized. Another diagnostic sign of appendicitis is limited fluid collection.

The main tactic in diagnosing acute appendicitis is dynamic observation, so control ultrasound provides important data. Signs of mesadenitis on ultrasound are an increase in the size of the mesenteric lymph nodes, which are located in a group.

Acute intestinal obstruction is characterized by a violation of the passage of food through the intestines. Ultrasound signs - dilated intestinal loops without signs of peristalsis with pendulum-like movement of intestinal contents.

In later stages, free fluid appears between the intestinal loops. For children, the most common cause of acute intestinal obstruction is intussusception. This condition is the penetration of one intestine into the lumen of another.

The cause of hepatic colic can be gall bladder and hepatic duct stones, biliary dyskinesia, and gall bladder polyps. Intraluminal formations in the gallbladder are well visualized using ultrasound.

The study of the thyroid gland, parathyroid glands, and adrenal glands is essential in the diagnosis of diseases of the endocrine system.

Thanks to ultrasound examination of structures that are located close to the surface of the skin, it has become possible to examine peripheral lymph nodes, salivary glands and their ducts, intradermal and subcutaneous formations, post-injection abscesses, edema and infiltration of subcutaneous fatty tissue.

The study of the peripheral vascular bed in children is possible through the study of the main arteries of the extremities, subcutaneous and deep veins of the upper and lower extremities. The study of the brachiocephalic arteries also provides important information. This manipulation makes it possible to determine thrombosis, stenosis and vascular anomalies.

Examination of the scrotal organs in boys can reveal undescended testicles into the scrotal cavity, orchiepididymitis, testicular torsion, varicoceles, cysts and tumors.

Also, complications during childbirth and birth trauma, convulsions serve as indications for performing an ultrasound of the brain. Such a study is possible due to the presence of fontanelles through which ultrasound is performed.

The diagnosis of hip dysplasia is based on the results of ultrasound diagnostics of the hip joints. Also, performing an ultrasound of joints in children helps to monitor their condition over time.

In newborns, ultrasound is performed to exclude congenital malformations that pose a threat to the child’s life, such as esophageal atresia, heart defects, gastrointestinal tract defects, central nervous system defects, as well as multiple developmental defects.

Conclusion

The use of ultrasound in pediatric practice makes an invaluable contribution to the diagnosis of various diseases in children of different ages. The information obtained during the study provides important diagnostic data for making a correct diagnosis in a sick child, and also helps to identify congenital developmental anomalies.

The value of the ultrasound diagnostic method is that it is absolutely harmless, safe for the child and does not require invasive intervention in the body. Also, there is no need for any complex preparation before the study. The data obtained should be interpreted taking into account the age and gender of the child.

Ultrasound examinations for children are usually carried out in children's clinics and hospitals, as well as in private centers. The reliability of the results obtained depends on the class of the ultrasound device, the experience and professionalism of the doctor who performs the manipulation, the preparation of the patient and the calm behavior of the child during the ultrasound examination.

Therefore, if there is a need for an ultrasound scan for a child, it is better to consult a good doctor who specializes in pediatrics and ultrasound diagnostics.