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Common abdominal emergencies in children.

James D'Agostino1

  • 1Department of Emergency Medicine, State University of New York, Upstate Medical University, Syracuse, New York, USA. dagostinj@upstate.edu

Emergency Medicine Clinics of North America
|February 6, 2002
PubMed
Summary

Emergency physicians must suspect serious abdominal emergencies in children, even with vague symptoms. Careful history, physical exams, and repeated observations are key for accurate pediatric abdominal pain diagnosis.

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Area of Science:

  • Pediatric Emergency Medicine
  • Gastrointestinal Emergencies in Children

Background:

  • Young children frequently present to emergency departments (EDs) with abdominal complaints.
  • Differentiating serious abdominal emergencies from less severe causes like constipation or gastroenteritis is crucial.

Purpose of the Study:

  • To emphasize the importance of a high index of suspicion for serious pediatric abdominal emergencies.
  • To highlight the diagnostic value of history, physical examination, and observation in pediatric abdominal pain.

Main Methods:

  • Thorough and complete history taking from parents and children.
  • Gentle yet comprehensive physical examinations.
  • Repeated examinations and patient observation.

Main Results:

  • Ancillary tests, including abdominal radiographs, can be unreliable in diagnosing pediatric abdominal emergencies.
  • Pediatric appendicitis may present with non-specific symptoms like lethargy or poor feeding.
  • Intussusception can present with intermittent symptoms, with children appearing playful between episodes.

Conclusions:

  • Emergency physicians must maintain a high index of suspicion for serious pathology in pediatric patients with abdominal complaints.
  • Patience, repeated examinations, and careful observation are essential for accurate diagnosis of pediatric abdominal emergencies.

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