Why is the evaluation of abdominal pain challenging in a child?
The diagnosis of abdominal pain can often be determined by a good history and physical examination, but these can be difficult to obtain from infants and young children. In addition, infants with abdominal pain may present with nonspecific signs, such as irritability, poor feeding, and lethargy. Toddlers and young children may report pain but are unable to provide further details, such as the quality, severity, or location of the pain. The history and physical examination of a child require time and patience and may be more difficult to obtain. The differential diagnosis of abdominal pain in children must include both common diseases and a host of disorders unique to the pediatric patient, such as congenital anatomic abnormalities, Henoch-Schönlein purpura, abdominal migraines, and metabolic disorders.
Marin JR, Alpern ER: Abdominal pain in children. Emerg Med Clin North Am 2011;29:401-428.