What are the two most common causes of acute abdominal emergencies in children? Appendicitis is the most common cause in the United States, followed by intussusception. Sources Pollack ES: Pediatric abdominal surgical emergencies. Pediatr Ann 2003;25:448-457.
Which blood tests may be useful in the evaluation of abdominal pain? Patients who have experienced persistent vomiting and appear dehydrated may have electrolyte abnormalities. In young infants, patients who will undergo surgery, or patients who are more severely ill, it may be more important to obtain blood studies to evaluate abdominal pain. The benefit …
Does the use of intravenous (IV) analgesia affect diagnostic accuracy in children with acute abdominal pain of unknown cause? Multiple studies with adults and children have shown that giving IV narcotics at adequate doses to decrease pain does not adversely affect the physical examination or diagnostic accuracy in patients with abdominal pain of unknown cause. In fact, …
What are some extra abdominal causes of abdominal pain? Pain originating at sites distant from the abdomen can manifest as abdominal pain. In processes such as lower lobe pneumonia, afferent nerves from the parietal pleura share central pathways with those that originate from the abdominal wall. Similarly, scrotal pain may be referred to the abdomen. …
What are the life threatening causes of abdominal pain? • Appendicitis • Intussusception • Incarcerated hernia • Trauma (accidental or inflicted injury) • Tumors • Sepsis • Malrotation/volvulus • Ectopic pregnancy • Diabetic ketoacidosis • Intra-abdominal abscess (pelvic inflammatory disease, inflammatory bowel disease) • Hemolytic uremic syndrome • Intestinal obstruction • Pancreatitis • Megacolon • Metabolic acidosis/inborn error of metabolism • Aortic aneurysm • Toxic ingestion (iron, lead, aspirin)
How to maximize the physical examination of a child with abdominal pain? In approaching any child with abdominal pain, one must take time to establish rapport. Essential information can be obtained before even touching the patient. Begin with observation, often best accomplished from outside the room. Notice the general appearance of the child. Is he …
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Causes of Acute Abdominal Pain in children Infancy (< 2 years of age) Preschool Age (2-5 years of age) School Age (> 5 years of age) Adolescent Common Colic (age < 3 mo), GERD, acute gastroenteritis, “viral syndromes” Acute gastroenteritis, UTI, trauma, appendicitis, pneumonia, asthma, sickling syndromes, “viral syndromes,” constipation Acute gastroenteritis, trauma, appendicitis, UTI, …