title: Cow's milk allergy: color Doppler ultrasound findings in infants with hematochezia.
abstract: OBJECTIVE
  ultrasound (US) has been an important diagnostic tool to identify several causes of gastrointestinal bleeding. Infants with cow's milk allergy (CMA) may present hematochezia and the confirmation of the diagnosis can be difficult. The aim of this study is to describe grayscale and color Doppler ultrasound findings in patients with CMA.
  
  
  METHODS
  we retrospectively studied 13 infants with CMA. All infants presented severe hematochezia and abdominal pain. All underwent an US study with the diagnosis of allergic colitis. This diagnosis was based on clinical findings, recovery after infant or mother exclusion diets in the case of exclusive breastfeeding and positive oral challenge test.
  
  
  RESULTS
  the mean age ranged from 1 to 6 months (mean=3.53). Seven out of 13 infants (53.8%) had grayscale and color Doppler sonographic repeated after exclusion diet. Twelve out of 13 (92,3%) showed abnormalities at US and CDUS at beginning. The positive findings suggesting colitis were thickened bowel walls and increased vascularity, especially in the descending and sigmoid colon. Colonoscopy and histopathological findings were compatible with allergic colitis. After a diet change the 13 infants recovered and their oral challenge tests were positive.
  
  
  CONCLUSIONS
  Doppler US may be very useful in diagnosing secondary colitis, such as CMA, and to exclude several other abdominal diseases that can emulate this disease.
authors.affiliation: Department of Pediatric Gastroenterology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil. Electronic address: mepifanio@hotmail.com.
authors.forename: Matias
authors.initials: M
authors.lastname: Epifanio
authors.forename: Jose Vicente
authors.initials: JV
authors.lastname: Spolidoro
authors.forename: Nathalia Guarienti
authors.initials: NG
authors.lastname: Missima
authors.forename: Ricardo Bernardi
authors.initials: RB
authors.lastname: Soder
authors.forename: Pedro Celiny Ramos
authors.initials: PC
authors.lastname: Garcia
authors.forename: Matteo
authors.initials: M
authors.lastname: Baldisserotto
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging*; D003092:Colitis / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging* / Q000178:diet therapy / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D016269:Milk Hypersensitivity / Q000175:diagnosis* / Q000178:diet therapy; D011350:Proctocolitis / Q000175:diagnosis* / Q000276:immunology; D012189:Retrospective Studies; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
keywords: Alergia ao leite de vaca; Colite; Colitis; Cow's milk allergy; Ultrasound; Ultrassom