Acute abdomen can be defined as "A syndrome induced by wide variety of pathological conditions that require emergent medical or more often surgical management" [1].There are a plethora of causes that can lead to acute abdomen in children, they vary depending on the ages of the children and can be divided into diseases that can be treated with medical care and those in which emergency surgical intervention must be considered [2]. Ultrasonography is the initial choice in the diagnosis of the different causes of acute abdomen in children [3, 4]. It is very useful as it is non-invasive, cost- effective, repetitive, with no radiation exposure, as good as laparoscopy, can be done even in patients with scarred abdomen [5].

-Patient preparation:

• No specific preparation is needed.

• Demographic data including age, sex, detailed history, clinical presentation, laboratory tests, and data of any other investigations or operation will be obtained.

• Clinical examination will be done in emergency pediatric unit for provisional diagnosis.

  -Study instruments:• Patients will examined by Grey-Scale Ultrasonography (U/S) combined with Color Doppler Ultrasonography (CDUS).

  3-Technique of examination

• will be in supine position.

• Patient First examination of whole abdomen will be done by Grey -Scale U/S using both 3.5 MHZ and 7.5 MHZ transducers .It will be done in both longitudinal ( parallel to long axis of the patient ) and transverse ( perpendicular to long axis of the patient ) orientation .

• Then finally examination by Color Doppler US will be done for assessment of organ perfusion and diagnosing inflammation.

Inclusion Criteria:

• -In this study, 100 patients referred from the emergency Pediatric Unit for the assessment of the cause of acute abdomen.

Exclusion Criteria:

• - Patients of age group above 18 years
• Patients with trauma.

patients referred from the emergency Pediatric Unit for the assessment of the cause of acute abdomen from age of 1 day to 18 years.