Toddler with drainage of stool from the umbilicus

Meckel’s scan of Meckel's diverticulum
AP delayed image (left) from a Tc-99m pertechnetate scan (Meckel’s scan) shows a focal round concentration of radiotracer in the right lower quadrant superior and lateral to the midline bladder which is seen in the middle of the lower abdomen superior to the bladder on the lateral (right) delayed image.

The diagnosis was Meckel’s diverticulum with a patent omphalomesenteric duct.

Teenager with left scrotal mass

US of varicocele
Sagittal greyscale US of the left scrotum (upper left) shows a serpiginous appearing mass in the superior aspect of the scrotum which during a Valsalva maneuver (upper right) increases in size. Sagittal color US of the left scrotum (lower left) shows the mass to be composed of blood vessels that have increasing venous flow seen through them during a Valsalva maneuver (lower right).

The diagnosis was varicocele.

School ager with appendectomy 3 months ago, now with abdominal pain and vomiting

Surgical image of small bowel obstruction due to abdominal adhesions
Surgical image shows dilated and congested loops of small intestine in the upper right corner and normal sized decompressed loops of small bowel adjacent to them. A volvulus was noted at the level of the terminal ileum, caused by adhesions from the cecum to the small bowel, forming a closed loop obstruction that was causing bowel wall congestion.

The diagnosis was small bowel obstruction due to abdominal adhesions.

Toddler with presumed urinary tract infection

MRI of Wilms tumor
Sagittal US of the left kidney (upper left) shows a round hyperechoic lesion in the lower pole of the kidney. Axial T2 MRI without contrast of the abdomen (upper right) and coronal T1 MRI without (lower left) and with (lower right) contrast of the abdomen shows a well-circumscribed, solid T1 hypointense and T2 isointense mass in the lower pole of the left kidney that enhances minimally.

The diagnosis was Wilms tumor of the left kidney.

Toddler with a fever

US of acute pyelonephritis / acute lobar nephronia
Sagittal US of the right kidney (above) shows an ill-defined hypoechoic mass in the right upper pole that is obscuring the normal outline of the echogenic fat in the renal hilum. The mass was hypoperfused on color and power doppler US. AP image from a voiding cystourethrogram (below) shows bilateral vesicoureteral reflux, grade II on the left and grade III on the right

The diagnosis was acute pyelonephritis in a patient with vesicoureteral reflux.

School ager with bilateral abdominal masses

CT of Burkitt lymphoma of kidney
Coronal T1 MRI without contrast of the abdomen (upper left) shows bilateral enlarged kidneys which after the administration of contrast (upper right) is seen to be due to multiple non-enhancing renal masses. Transverse US of the liver (below) shows a round hypoechoic mass in the liver, superior and to the left of the gall bladder.

The diagnosis was Burkitt lymphoma with renal and liver involvement.