II. Causes: Genitourinary and Retroperitoneal

  1. Hydronephrosis (e.g. vesicoureteric reflux)
  2. Bladder enlargement
  3. Renal vein thrombosis
  4. Cystic Kidneys (e.g. Multicystic dysplastic Kidneys)
  5. Mesoblastic nephroma
  6. Hydrocolpos
  7. Ovarian Mass (e.g. Ovarian Cyst, teratoma)
  8. Adrenal Hemorrhage
  9. Neoplasm (e.g. Neuroblastoma, Rhabdomyosarcoma)

III. Causes: Gastrointestinal

  1. See Hepatomegaly in Newborns
  2. See Splenomegaly in Newborns
  3. Gastrointestinal Duplications
  4. Meconium ileus
  5. Mesenteric or omental cyst
  6. Pyloric Stenosis
  7. Volvulus

IV. Evaluation

  1. Abdominal XRay suggests Intestinal Obstruction
    1. Contrast radiographs
    2. Consult with pediatric surgery
  2. Abdominal Ultrasound
    1. Distinguishes cystic and solid lesions
    2. Evaluates Hydronephrosis, Renal Cysts, Bladder size
    3. Identifies Pyloric Stenosis
    4. Identifies Ovarian Mass
  3. Other imaging
    1. Abdominal MRI
    2. Abdominal CT
      1. See CT-associated Radiation Exposure (avoid if possible)

V. Labs

  1. Complete Blood Count
  2. Serum Electrolytes
  3. Urinalysis

VI. 'References

  1. Cloherty (1991) Neonatal Care, p. 501-4
  2. Fuloria (2002) Am Fam Physician 65(2):265-70 [PubMed]

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