Arredondo Anthony R, Wilkinson Matthew, Barber Richard B, Gilmartin Thomas, Levine Marla C
Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine, Houston, Texas, USA.
Department of Pediatric Emergency Medicine, UT Austin Dell Medical School, Austin, Texas, USA.
J Ultrasound Med. 2022 May;41(5):1061-1067. doi: 10.1002/jum.15787. Epub 2021 Jul 19.
The detection of intraperitoneal free fluid (FF) is an important finding in the sonographic evaluation of the pediatric abdomen, especially in the context of blunt abdominal trauma. One specific challenge is differentiating physiologic from pathologic FF. The purpose of this study was to determine with ultrasound the prevalence, location, and volume of intraperitoneal FF in healthy pediatric patients and its relation to pubertal status and gender.
Healthy children between the ages of 1 and 17 years who presented to the emergency department with non-abdominal complaints were evaluated for physiologic intra-abdominal fluid. Point-of-Care Ultrasound (POCUS) was performed, utilizing the Focused Assessment with Sonography in Trauma (FAST) examination.
A total of 325 pediatric patients were analyzed. Intraperitoneal FF was found in 52 children (16.0%, 95% CI: 12.0-20.0%). The pelvis was the only region where FF was located. The prevalence of FF was nearly equivalent between male and female children (15.4% vs 16.7%, P = .76). There was a higher prevalence of FF identified in the prepubertal subgroup compared to the pubertal group (20.0% vs 11.3%, P = .03). Seventy-seven percent of children with FF had a fluid volume of less than 1 mL.
Physiologic FF of less than 1 mL within the pelvis is a common finding in the pediatric population. There was no difference in the rate of FF identified by gender, but there was a higher prevalence of FF among prepubertal children.
检测腹腔内游离液体（FF）是小儿腹部超声评估中的一项重要发现，尤其是在钝性腹部创伤的情况下。一个特殊的挑战是区分生理性FF和病理性FF。本研究的目的是通过超声确定健康小儿患者腹腔内FF的患病率、位置和体积，及其与青春期状态和性别的关系。
对因非腹部疾病就诊于急诊科的1至17岁健康儿童进行生理性腹腔内液体评估。采用创伤超声重点评估（FAST）检查进行床旁超声（POCUS）检查。
共分析了325例儿科患者。52例儿童（16.0%，95%CI：12.0 - 20.0%）发现腹腔内有FF。盆腔是FF唯一所在区域。男女儿童FF的患病率几乎相当（15.4%对16.7%，P = 0.76）。与青春期组相比，青春期前亚组中FF的患病率更高（20.0%对11.3%，P = 0.03）。77%有FF的儿童液体量小于1 mL。
盆腔内小于1 mL的生理性FF在儿科人群中是常见发现。FF的检出率在性别上无差异，但青春期前儿童中FF的患病率更高。
