USG AND PEDIATRIC ABDOMEN :

• Renal masses -
  
  They are the commonest course of abdominal mass in both infants and children, accounting to more than 50%.

Solid renal masses - < 6 years - Mesoblastic nephroma >6 years - Wilm's tumour

Bilateral renal masses -
• Autosomal recessive polycystic renal disease - usually associated with congenital hepatic fibrosis with/without portal hypertension.
• Nephroblastomatosis
• Renal vein thrombosis
  
  Cystic renal masses -
  • Hydronephrosis accounts for 50% of the renal masses. Etiological factors could be PUJ obstruction, VUR, megaloureter, VUJ obstruction, duplex system, posterior urethral valves, bladder outlet obstruction.
  • Multicystic dysplastic kidney disease
  • Autosomal dominant polycystic renal disease
  • Autosomal recessive polycystic renal disease
  • Tuberous sclerosis
  
  
• Adrenal masses -
  • Neuroblastoma - second commonest abdominal mass found in children after Wilm's tumour.
  • Adrenal haemorrhage
  • Other adrenal masses are Pheochromocytomas (extremely rare) and adrenal carcinoma


• Hepatic masses -
Hepatic masses in childhood are relatively uncommon.


Focal hepatic masses


• HEPATOBLASTOMA - Third commonest malignancy seen in childhood after Wilm's tumour and neuroblastoma.
• HEPATOCELLULAR CARCINOMA
• HEMANGIOMAS & HEMANGIOENDOTHELIOMAS
• METASTASIS - Wilm's, neuroblastoma, lymphoma, leukemia, rhabdomyosarcoma
• MESENCHYMAL HAMARTOMAS
• ADENOMAS, TERATOMAS
• INFECTION - AMOEBIC/PYOGENIC ABSCESS, HYDATID CYST.


Diffuse hepatic lesion


• HEPATOMEGALY - Glycogen storage disease, fatty liver, infections (malaria, typhoid)