Elevated renal rind.

We describe the findings from a group of five infants ranging in age from 3 weeks to 13 months who had shock of differing causes. In each case, sonographic evaluation of the abdomen revealed bilateral perirenal hyperechoic bands several millimeters thick, surrounding a thin, hypoechoic rim of fluid. The findings were identified during the acute phase of each child's illness and persisted after the patient's condition had clinically improved, eventually resolving in the three surviving children. We have dubbed this sign the elevated renal rind. We believe that the changes are likely secondary to systemic inflammatory mediators and do not reflect localized intraabdominal disease.