The voiding cystourethrogram and excretory urogram have been considered essential parts of the evaluation of girls with urinary tract infections. To evaluate the usefulness of these procedures, 523 examinations in girls with urinary tract infections were reviewed retrospectively. The major finding on voiding cystourethrograms was vesicoureteral reflux, occurring in 36% of the children. Of the total group, 8% had excretory urographic evidence of parenchymal scarring. Higher grades of reflux were associated with an increase in parenchymal scarring. All urethras were normal, and only one paraureteral diverticulum was identified. Bladder emptying was incomplete in 46% of the patients. Ovarian radiation doses were measured with "low-dose" and standard systems. On the basis of this study, traditional approaches to the standard workup are questioned.

We describe a technique wherein an endotracheal tube is used as a sheath for a feeding tube, which has been placed through the wall of a gastrostomy catheter, to allow selective intubation of the duodenum.

The radiographic and clinical findings of 57 infants and children demonstrating pharyngonasal reflux during barium swallow were reviewed. Pharyngonasal reflux is most frequent in the first 3 months of life and may occur in children with apneic episodes. Clinical symptoms in this group of children generally clear, even when reflux is severe. Pharyngonasal reflux may be associated with prematurity, neuromuscular disease, velopharyngeal incoordination, and other conditions but is usually of no consequence in very young infants.

Newborn infants with severe respiratory distress syndrome have an increased incidence of pulmonary interstitial emphysema, pneumomediastinum, and pneumothorax. A chest tube inserted for treatment of a pneumothorax may inadvertently perforate the lung. Recognition of chest tube perforation can be suggested by the occurrence of: (1) persistent or repeated pneumothoraces despite the presence of a chest tube and (2) atelectasis and/or infiltrate near the end of the chest tube.

Traumatic atlanto-occipital dislocation with survival is possible and, in fact may be relatively more common than once thought. The spectrum of neurologic manifestations is broader than previously described and does not necessarily end in death or tragic neurologic deficit. Radiographic diagnosis of this injury may be difficult, particularly in the longitudinal distraction-dislocation type. Although several methods have been proposed to evaluate the atlanto-occipital relationship, none of these is infallible in the recognition of distraction injury in children. Immobilization rather than skeletal traction provides sufficient immediate stabilization when the dislocation at the atlanto-occipital junction is of the longitudinal distraction type. Three cases are reported: in one, death occurred early; in the second, recovery was partial, but sudden death occurred 2 years later; the third child recovered fully.

Normal dilatation of the proximal ureters in childrenRA Kaufman, JS Dunbar and DE GoleAudio Available | Share

Two children, one with an internal laryngocele and the other with a lateral saccular cyst are described. The anatomy, classification, and history of these unusual lesions are described. The diagnosis and management are discussed. An external approach is suggested for the more persistent cases.

Three cases of perforation of the colon distal to an ileocolic intussusception are presented. Two cases were associated with attempted hydrostatic reduction of the intussusception, while the other was discovered at operation. The mechanism of this complication is not clear. When performing a contrast enhanced examination of the colon and there is a risk of perforation: (a) dilute water-soluble contrast medium should be used; (b) special attention should be paid to the colon distal to the intussusception; and (c) should contrast material be observed in the peritoneal cavity, the enema reservoir should immediately be lowered to the floor to siphon off the liquid from the colon.

The authors review the anatomy of the pleural reflection of the right lung against the middle mediastinum in childhood. In 505 consecutive normal frontal radiographs of children, from birth to sixteen years, this pleural reflection (also known as the pleuro-esophageal line) was visible in 83%. The entire reflection from thoracic inlet to diaphragm was clearly seen in 13%, chiefly in upright, deep-inspiration, well penetrated radiographs. It is a radiographic landmark in the middle mediastinum, particularly well seen in childhood, and its use in assessment of mass lesions, cardiomegaly and lung collapse is described.

INTRODUCTION OF THE CALDWELL LECTURER, 1973J. S. DUNBAR, M.D., F.R.C.P.(C)Audio Available | Share

HomeRadiologyVol. 106, No. 2 PreviousNext Book ReviewPediatric CardiologyJ. S. Dunbar, D. E. NewmanJ. S. Dunbar, D. E. NewmanJ. S. DunbarD. E. NewmanPublished Online:Feb 1 1973https://doi.org/10.1148/106.2.368MoreSectionsPDF ToolsAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookXLinked In Article HistoryPublished in print: Feb 1973 FiguresReferencesRelatedDetailsRecommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 106, No. 2 Metrics Altmetric Score PDF download

Siu, Connie M. MBBS; Dunbar, J S MD; Wright, Virginia J. MD; Hardwick, D F MD Author Information

Pneumothorax and pneumoperitoneum were roentgenographically demonstrated and appeared to occur simultaneously in a premature newborn infant with hyaline membrane disease. It was surmised clinically and rotengenographically that the intraperitoneal air had reached the peritoneal cavity from mediastinal or pleural gas, and did not represent a perforated viscus, a finding confirmed by contrast studies and at autopsy. Postmortem examination following death from hyaline membrane disease and intracranial hemorrhage confirmed that there was neither perforation of an abdominal viscus, nor any evidence of peritonitis. This case emphasizes the importance of recognizing that the sudden appearance of pneumoperitoneum in the newborn period may be a complication of pneumomediastinum or pneumothorax or both and that, with appropriate studies, unnecessary laparotomy may be avoided.

PNEUMOTHORAX AND PNEUMOMEDIASTINUM ASSOCIATED WITH RENAL MALFORMATIONS IN NEWBORN INFANTSLEO STERN, M.D., BARRY D. FLETCHER, M.D., J. SCOTT DUNBAR, M.D., M. N. LEVANT, M.D. and JOHN S. FAWCETT, M.D.Audio Available | Share