Can sonographic findings stop surgical intervention in acute abdomen in childhood? –7-year old boy with hereditary angioedema (case report)

Objectives: Severe attacks of abdominal pain with tedner and rigid abdominal wall in children are often difficult to distinguish from acute abdominal conditions. There are some conditions with sever abdominal pain in childhood that can prompt unnecessary exploratory laparotomy. Only a few reports have been published about the role of sonography in the diagnosis of abdominal HAE attack in children.

Methods: We described sonographic fidings during first sever attack of abdominal pain in 7-year old boy with known hereditary angioedema (HAE).

Results: Sonography detected ascites with thickened peritoneum and decreased bowel motility. The intestinal wall was thickened with presence of intramucosal hypoechoic lacunae and narrowed lumen of bowel loop. All sonographic changes resolved after therapy.

Conclusions: These sonographic fidings are specific and characteristic of abdominal HAE attack in childhood and have been useful to prevent unnecessary surgery. In our opinion sonography can be also useful in the diagnosis of HAE in children with reccurent abdominal pain attacks as the only clinical manifestation of this disorder.