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Multimodality Diagnosis of Mesenteric Ischemia

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Published on: July 21, 2023

Navigating recurrent abdominal pain through clinical clues, red flags, and initial testing.

Joshua D Noe¹, B U K Li

¹Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, W1 53226, USA.

Pediatric Annals

|May 30, 2009

Summary

Diagnosing recurrent abdominal pain in children involves differentiating functional disorders from organic diseases. A thorough history, physical exam, and Rome III criteria help identify functional pain, guiding appropriate management strategies.

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Published on: December 21, 2012

Area of Science:

Pediatric Gastroenterology
Clinical Diagnosis
Internal Medicine

Background:

Recurrent abdominal pain is a frequent pediatric complaint.
Distinguishing functional abdominal pain disorders from organic diseases presents a diagnostic challenge.
Common functional disorders include functional dyspepsia, irritable bowel syndrome, functional abdominal pain, and abdominal migraine.

Purpose of the Study:

To outline a systematic approach for evaluating children and adolescents with recurrent abdominal pain.
To differentiate functional abdominal pain from organic etiologies.
To guide initial management and referral decisions.

Main Methods:

Detailed patient history and physical examination.
Application of Rome III criteria for functional gastrointestinal disorders.
Identification of diagnostic clues and red flags for organic diseases.
Initiation of empiric therapeutic trials when appropriate.

Main Results:

A structured diagnostic approach can effectively differentiate functional from organic causes of recurrent abdominal pain.
Rome III criteria aid in the positive identification of functional disorders.
Red flags and specific clues guide the suspicion of organic disease requiring further investigation.

Conclusions:

Confident initial evaluation, management, and referral for pediatric recurrent abdominal pain are achievable.
A systematic approach integrating symptom-based criteria and red flag identification is crucial.
Empiric therapeutic trials can be initiated once a diagnosis is suspected or made.