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A series of 63 patients with suspected adrenal disease was evaluated by computed tomography (CT). In 15 additional patients CT diagnosed unsuspected adrenal disease. The CT results were correlated with surgical, postmortem, or compelling clinical data. In those patients with adequate visualization of both adrenals, CT correctly identified all adrenal masses subsequently proven at surgery or postmortem examination. CT accurately predicted the presence or absence of a unilateral adrenal neoplasm in patients with Cushing's syndrome and primary aldosteronism. Unsuspected primary or metastatic neoplasms of the adrenals were occasionally detected in patients scanned for other reasons. CT is a safe and accurate method of evaluating patients with suspected adrenal disease.

The authors report the cases of 2 children, 12 and 4 years old respectively, presenting with a lipoma of the postero-superior mediastinum, that were investigated within a 6 year-period. Costal erosions were present in both cases with intraspinal extension in one child. Standard X-ray films should have led to the diagnosis, because of the relative low density of the mass considering its volume. In one case, CT scan confirmed the homogeneous fatty nature of the mass.

Natural splenorenal shunts were observed in 5 children with portal vein obstruction. In all 5 cases, 1 or several criteria were found suggesting that such anastomoses were functional. For a better understanding of the spontaneous improvement of some children with portal vein obstruction, it would be advisable repeat radiologic, fiberoptic and ultrasonographic investigations at regular intervals in such children.

Ultrasonic examination was performed in 7 infants with renal venous thrombosis. Early findings included renal enlargement, increased echogenicity with a low cortico-medullary difference and very thin intra-renal excretory cavities. Thrombosis of the inferior vena cava was seen in one case. Ultrasonic follow-up was in agreement with findings on IVP. In favorable cases all findings returned progressively to normal. In cases with poor prognosis kidney size decreased but echogenicity and renal cavities remained unchanged. In addition, ultrasonic examination is useful in differentiating renal venous thrombosis from other causes of retroperitoneal masses in infancy.

The authors report 7 cases of neo-natal adrenal hematoma diagnosed by ultrasound. A traumatic delivery was found in 4 cases. In 4 cases a flank mass was palpated. In 3 cases the adrenal hematoma was asymptomatic, discovered by echotomography. I.V.P. showed a typical appearance in only 1 case out of 5. The first ultrasonic examination was performed between day 5 and day 12. It showed a fluid filled mass in 5 cases and a predominantly fluid mass in 2 cases. Both sides were involved twice. The ultrasonic follow-up 8 days later always showed a decrease in size, in 1 cases calcifications appeared. The authors compare their results with those of the literature and discuss the differential diagnosis with neo-natal neuroblastoma.

The practice of systematic X ray screening for congenital dislocation of the hip leads to the discovery of a somewhat rare anomaly: the calcification of the vestigial segment of the umbilical artery. The authors describe 6 cases of this peculiar condition of which the diagnosis is easy and does not necessitate any complementary investigation. This finding has no pathological significance; this condition must be considered as a normal variant.

Thirty-eight children were operated on between 1974 and 1979 at the hôpital Trousseau for a volvulus of the small intestine due to an abnormal mesenteric rotation. These children may be classified into 3 groups: (1) peracute volvulus, most often neonatal, with intestinal necrosis, generally lethal; (2) acute volvulus, also neonatal, with a favorable outcome after treatment; (3) chronic volvulus, which may occur at any age and may be symptomatic or not. They carry a risk of acute complication, with possible intestinal necrosis. Radiology plays a part in the diagnosis of such anomalies of rotation complicated with volvulus. Upper gastrointestinal tract opacification with barium sulfate, showing the abnormal position of the duodenojejunal flexure and a corkscrew appearance allows surgical decision, as in all cases, treatment is surgical. It consists of derotation and setting in complete common mesentery position.

The authors report 18 cases of pelvic rhabdomyosarcomas in children examined at presentation and followed on US and CT. There were 11 boys, 7 girls; tumor location was bladder, prostate or uterus in 12, perineum in 4, buttock in 2. US is good to define tumoral extension within the bladder CT is better to delineate the extension outside the bladder and regional spread to iliac nodes. CT is the only useful examination for perineal tumors. During chemotherapy US can be frequently repeated to appreciate tumoral regression and to give measurement of the mass. Preoperative CT should be performed when tumoral regression seems sufficient to permit complete tumoral excision without pelvic exenteration. Correlation between US and CT and surgical findings proved to be good. US and CT are also very useful in the follow-up when the child has finished treatment as it can demonstrate a local recurrence before clinical symptoms appear. However, post-surgical and post-radiation changes may be difficult to recognize. These aspects are discussed.

A massive haemothorax occurring acutely during haemodialysis in a child of 8 1/2 years is reported. The pleural effusion occurred synchronously with a round, dense shadow in the parenchyma similar to an intra-pulmonary haematoma. The density became bullous in six weeks and disappeared in three months. The suggested cause of this haemothorax is a pulmonary embolism whose site of origin was the arteriovenous fistula. This would have been responsible for the adjacent pleural and parenchymal haemorrhage in the lung. The heparin given intravenously at the beginning of the haemodialysis session probably contributed to the size of the haemorrhage.

The authors describe a case of multiple tendinous calcification which was of unusual interest because of its localization (left gluteus medius tendon), the associated fever, its rapid favourable evolution (72 hours), and the disappearance of radiological signs of calcification.

The respective values of intravenous pyelography, ultrasound examination and computerized tomography are compared with the findings at surgery and with histological data in 28 children with malignant tumors of the lumbar fossa. Ultrasound proved to be of significant value in assessing the extent of the tumor. At the present time, computerized tomography is only indicated when intravenous pyelography and ultrasound examination fail to provide adequate information.