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PHLEBO-ARTERIO-UROGRAPHY IN THE ASSESSMENT OF ABDOMINAL MASSES IN CHILDREN

STEPHEN GAMMILL M.D.1, FRANCIS PUYAU M.D.2, and HAROLD NEITZSCHMAN M.D.3

1 Associate Professor of Radiology, University of Tennessee Medical School, Memphis, Tennessee.
2 Professor of Radiology and Pediatrics, Louisiana State University Medical School; Assistant Radiologist in charge of Pediatric Cardiac Catheter Laboratory, Charity Hospital.
3 Assistant Radiologist, Charity Hospital.

Phlebo-arterio-urography consists of opacifying the inferior vena cava with contrast material followed by rapid filming to obtain an intravenous aortogram, and delayed films to obtain an intravenous pyelogram. Tomography may be added as needed. We have found this technique to often be the only diagnostic procedure necessary for the work-up of abdominal masses in children.

The injection may be made into the saphenous vein through a cut-down procedure or, preferably, through a catheter placed into the inferior vena cava via the femoral vein.

We recommend sedating all candidates for this procedure, even newborns, as sedation will prevent vociferous crying, which often results in shunting contrast material away from the inferior vena cava into the paravertebral veins.


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