Imaging diagnosis and differential diagnoses of pediatric infectious enteritis

Abstract

Children presenting with abdominal pain and diarrhea are encountered on a daily basis in pediatric emergency practice. Imaging is not required for diagnosis of infectious enteritis itself, but computed tomography (CT) is frequently performed in clinical practice to assess patients with a poor general condition or to evaluate potentially severe complications. Therefore, radiologists need to recognize the characteristic imaging findings of infectious enteritis and to differentiate this condition from non-infectious enteritis and surgical abdominal diseases. In this article, we first review the basic imaging findings for pediatric abdominal infections based on the underlying pathophysiology of viral and bacterial enteritis. We then summarize the clinical features, disease distribution, characteristic imaging findings, and important complications associated with common pathogens, including Campylobacter, Salmonella, Yersinia, enterohemorrhagic Escherichia coli, and viral gastroenteritis. Furthermore, we discuss conditions of non-infectious enteritis that should be considered in the differential diagnosis, including eosinophilic gastroenteritis, IgA vasculitis, lupus enteritis, and Crohn disease, and highlight key imaging features that help distinguish these entities from infectious causes. In imaging evaluation of pediatric enteritis, a comprehensive and systematic assessment of bowel wall layering, disease distribution, and extraintestinal findings is required for accurate diagnosis and appropriate clinical management.