Terminal Ileum and Mesenteric Vessels; Two Fundamental Gateways for Ultrasound Examination in Children with Acute Abdomen: A Review

Acute abdomen is a major cause of pediatric hospitalization that can represent a variety of conditions, some of which carrying a high risk of complications. Ultrasonography is usually the primary diagnostic method and provides quick aid in decision-making for the surgeons. It is cardinally important to follow a logical and comprehensive approach in ultrasound examination of children with acute abdomen, to reduce the chance of diagnostic pitfalls and prevent unnecessary delays in surgical interventions. However, there is still controversy regarding the best starting point and the optimal sequence of ultrasonography. In this review, we have summarized the most relevant literature regarding the ultrasonography of acute abdomen in the pediatric population by reviewing the most common causes of acute abdomen that require intervention and lead to complications in this age group. We conclude that ultrasound examination through a systematic approach focusing on terminal ileum and mesenteric vessels can aid timely diagnosis of the most important etiologies and expedite the management of critically ill patients.