The use of abdominal ultrasound as a screening method in the neonatal and infant period – is it useful?

Introduction: Over the last few years abdominal ultrasound has become a very useful and accessible method for exploring the pediatric gastrointestinal pathology.

Study objective: Assessing the need to perform an abdominal ultrasound in the neonate and infant, as a screening procedure, in order to find evidence of malformative or tumoral pathology.

Methods: Abdominal ultrasounds were performed on 769 patients hospitalized in our clinic during July 2013 – March 2015. The patients were aged between 0 – 1 years, with an average of 3 ± 2.5 months. Of these, 450 patients (58.51%) received a routine abdominal ultrasound without any clinical evidence to justify this investigation.

Results: The most common pathology was that of the reno-urinary tract: renal malformations – 1 case (cystic renal dysplasia), Ist and IInd degree hydronephrosis – 75 cases (16.67%), IIIrd and IVth degree hydronephrosis – 18 cases (4%); other findings consisted in ovary cysts – 39 patients (8.6%), vascular portal malformations – 5 cases (1.1%), digestive malformations (midgut cyst) – 2 cases (0.04%), tumoral pathology – 10 cases (2.2%), congenital spleen cyst – 1 case.

Discussions: The relatively high prevalence of abdominal pathology (75 cases, 28%) detected accidentally by performing routine abdominal echography in these patients has not changed the therapeutical approach in 92% of cases. 6 cases were subject to surgical referrals. 2 cases required immediate surgery (neuroblastoma and nephroblastoma), while other 2 cases would undergo surgery at a later stage.

Conclusions: Abdominal ultrasound during the neonatal period and infancy is important in order to establish a complete diagnosis and subsequent monitoring of these cases.