CASE REPORT   

Journal of Radiological Review 2021 September;8(3):270-4

DOI: 10.23736/S2723-9284.21.00154-4

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Role of ultrasound in intestinal infections: a pediatric case of Campylobacter pancolitis

Divina D’AURIA ¹ ✉, Anna CASTALDO ¹, Angela SIERVO ¹, Iolanda CAPALDO ¹, Carolina D’ANNA ², Vincenzo TIPO ², Sonia TAMASI ³, Massimo ZECCOLINI ³

¹ Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy; ² Pediatric Emergency Department, AORN Santobono-Pausilipon Children Hospital, Naples, Italy; ³ Unit of Radiology, AORN Santobono-Pausilipon Children Hospital, Naples, Italy

Campylobacter enterocolitis is one of the most common gastrointestinal infections in the pediatric population. The most frequent clinical manifestations include fever, abdominal pain, diarrhea and/or dysentery. The infection is usually self-limited and has a conservative management. When clinical manifestations are significant or other pathologies need to be ruled out, laboratory tests - including stool analysis - as well as diagnostic imaging evaluation, may be required. Ultrasound (US) represents the best imaging approach in children with abdominal pain and gastrointestinal symptoms as it is widely available, does not use ionizing radiation or contrast agents and does not need sedation. US is useful to confirm the clinical suspicion of intestinal inflammation and allows to exclude other mimicking pathologies such as appendicitis and intussusception, allowing the most appropriate management and avoiding unnecessary treatment. If performed by expert operators, this technique can provide detailed information on localization (colon and/or small bowel), degree of mural thickening and layering as well as on the extramural extension of inflammation. It can also be used in the follow-up to evaluate the response to treatment, thanks to its easy repeatability and non-invasiveness. We report a case of Campylobacter pancolitis in an 11-year-old child, who presented with abdominal pain and repeated episodes of bloody diarrhea. US was supportive to clinic evaluation and laboratory tests as it allowed us to exclude other pathologies, assess the extent of the disease to the entire colon and the absence of complications. Here, we will discuss the main ultrasonographic findings of infectious enterocolitis and main differential diagnoses, emphasizing the potential and limitations of US in the evaluation of gastrointestinal pathologies in pediatric age.

KEY WORDS: Campylobacter; Enteritis; Colitis; Diarrhea; Ultrasonography