OBJECTIVE: The present study was aimed at sonographically determining the liver size in healthy newborns, infants and children under 7 years of age, correlating results with age, sex, height, body weight and body mass index. MATERIALS AND METHODS: A total of 584 healthy children subdivided into 11 age groups were evaluated with measurements of the left lobe craniocaudal diameter at the midsternal line, and the craniocaudal diameter of the right lobe posterior surface at the midclavicular line. The following tests were utilized for statistical analysis: a) Pearson's correlation coefficient (correlation study); b) non-paired Student's t-test (comparison of measures between sexes); c) nonlinear regression models (nomograms). RESULTS: The liver size presented a progressive growth from the birth up to the age of 7, proportionally lower than the body growth, in correlation with age, height and body weight (r > 0.70). Correlation with the body mass index was not observed (r < 0.11). There was no significant difference in liver size between male and female individuals. CONCLUSION: Liver size was sonographically determined in healthy children under the age of 7 by means of a standardized method, demonstrating a strong correlation with age and anthropometric indicators. Nomograms demonstrate the typical variations of the liver size in the population evaluated with a different growth pattern for each hepatic lobe.

Keywords: Liver, Liver size, Biometry, Child, Ultrasonography

The authors report a case of congenital hydrocolpos due to vaginal malformation (vaginal septae) associated with ectopic ureter and renal displasia. Several imaging diagnostic procedures (ultrasonography, nuclear medicine, intravenous urography and computed tomography) were performed. A review of the literature on hydrocolpos and its association with urinary malformations is also presented.

Keywords: Hydrocolpos, Vaginal malformation, Renal displasia

OBJECTIVE: The objectives of this study are: (1) to standardize the sonographic biometry method to determine the size of the liver in children in order to obtain a greater precision of the section planes and to minimize operator-dependant error; (2) to test intra-observer reproducibility. CASUISTIC AND METHOD: Sonographic measurements of the liver were performed by a single examiner in 32 children (aged 0 to 6 years) with no liver or biliary system disease. The measurements were done in two different occasions (exams 1 and 2) to determine reproducibility. The section planes were based on external orientation lines related to intra-abdominal anatomic references, both extra and intra-hepatic. The values obtained in exams 1 and 2 were compared using a Student's paired t-test. The Pearson's coefficient was employed to determine the correlation among parameters as well as the correlation between the children's age and the difference in the values of exams 1 and 2. RESULTS: The statistical analysis revealed no significant intra-observer variability and no significant correlation between measurements' difference and children's age. In general, parameters were directly and highly correlated (r > 0.60). CONCLUSION: We concluded that the method is reproducible when performed by a same examiner. The measurements of the cranio-caudal diameter at the midsternal line and the posterior cranio-caudal diameter at the midclavicular line, based on intra-hepatic anatomic references, were precise and easier to perform than other routine measurements.

Keywords: Liver size, Biometry, Children, Ultrasound

The authors report two cases of gastrocolic fistula caused by chronic therapy with indometacin in patients with Bartter's syndrome followed at the outpatients clinic of "Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo", Brazil. The diagnosis was suggested by a barium meal that showed a gastrocolic fistula between the greater curvature of the stomach and the transverse colon. Treatment was surgical in the both cases.

Keywords: Bartter's syndrome, Gastrocolic fistula, Indometacin, Barium meal

OBJECTIVE: To describe the radiological findings in pediatric patients with hematological or oncological diseases who also have an invasive fungal infection (IFI). MATERIALS AND METHODS: This was a retrospective study of all patients with IFI admitted to a pediatric hematology and oncology hospital in Brazil between 2008 and 2014. Clinical and demographic data were collected. Chest computed tomography (CT) scans of the patients were reviewed by two independent radiologists. RESULTS: We evaluated the chest CT scans of 40 pediatric patients diagnosed with an IFI. Twenty-seven patients (67.5%) had nodules with the halo sign, seven (17.5%) had cavities, two (5.0%) had nodules without the halo sign, and seven (17.5%) had consolidation. The patients with the halo sign and cavities were older (123 vs. 77 months of age; p = 0.03) and had less severe disease (34% vs. 73%; p = 0.04). Ten patients had a proven IFI: with Aspergillus sp. (n = 4); with Candida sp. (n = 5); or with Fusarium sp. (n = 1). CONCLUSION: A diagnosis of IFI should be considered in children and adolescents with risk factors and abnormal CT scans, even if the imaging findings are nonspecific.

Keywords: Mycoses/diagnostic imaging; Child; Adolescent; Immunocompromised host; Tomography, X-ray computed.