It's worth a second look: Sonographic identification of lymphoid hyperplasia of the pediatric bowel.

This article focuses on the sonographic presentation of lymphoid hyperplasia, a benign reactive proliferation of lymphatic tissue in pediatric patients that can mimic acute appendicitis or ileocolic intussusception on ultrasound. It emphasizes the importance of a systematic and detailed sonographic approach—including assessment of bowel wall thickness, vascularity, lymph nodes, and secondary inflammatory signs—to differentiate lymphoid hyperplasia from these higher acuity conditions. Recognizing characteristic features such as nodular hypoechoic thickening of the lamina propria and the absence of secondary signs can prevent misdiagnosis, unnecessary hospital admissions, repeat imaging, and surgical interventions. The article also highlights the role of sonographers in performing careful reassessment ("second look") and understanding normal anatomical variants to improve diagnostic accuracy in pediatric abdominal imaging.