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• W1978971017 abstract "In the first two years of life dehydration and acidosis occur not uncommonly and in some instances may result in complications or death unless recognized and treated early. The most frequent cause of such abnormal physiology is gastroenteritis, or, perhaps more precisely, diarrhea. The entire clinical complex of gastroenteritis, dehydration, and acidosis may often be accurately suggested by the chest radiograph alone. At the same time, the effect of acidosis and dehydration on the chest roentgenogram may be such that an erroneous diagnosis of bronchiolitis, asthma, obstructive emphysema, mucoviscidosis, or congenital heart disease may be made, and, from the appearance of the abdomen included on the film, small-bowel obstruction may be considered. It is important, therefore, that the radiologist be cognizant of the radiological findings and the underlying causes. The radiographic signs include, first, the bowel pattern of gastroenteritis, second, thinning of the soft tissues of the chest wall as a result of dehydration and, most important, the emphysematous appearance of hyperventilation as a result of acidosis and/or dehydration. The medical literature, upon incomplete perusal, appears devoid of references to this radiographic syndrome, yet more than 60 such cases have been collected since 1958, indicating that it is of rather common occurrence. Some were obtained retrospectively by employing cases indexed as diarrhea upon discharge from the hospital, but most were taken from the daily radiologic work load. Pathophysiology In early infancy, the mechanisms for proper regulation of body-fluid composition are much less adapatable than in later life, and the responses to infection and other disturbances of body function are more violent. Higher fevers and more severe vomiting and diarrhea result in increased water loss and electrolyte imbalance (6). Because of this, dehydration and resultant acidosis are more common, more marked, and more serious in infancy. Especially prone to cause dehydration and acidosis in these children is gastroenteritis with diarrhea. Diarrhea no longer holds first place among causes of infant mortality but it still results in many deaths and in some areas is the commonest summer ailment of children (3). Although many cases are due to specific enteric pathogens, such as Salmonella and Shigella, most cannot be attributed to a specific organism. Hot weather seems an important factor, probably due to its effect on improperly refrigerated milk and other food substances (3). No gross or microscopic pathology is found in the bowel other than distention, except in cases of specific infections, such as shigellosis, in which ileocolitis is usually observed (3). Hyperperistalsis is frequently present but the cause is unknown. Except in the infectious processes, no known irritant is found." @default.
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• W1978971017 date "1964-08-01" @default.
• W1978971017 modified "2023-09-26" @default.
• W1978971017 title "The Diagnosis of Dehydration, Acidosis, and Gastroenteritis in Infants from the Chest Radiograph" @default.
• W1978971017 doi "https://doi.org/10.1148/83.2.297" @default.
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