Beyond appendicitis: evaluation and surgical treatment of pediatric acute abdominal pain

Area of Science:

• Pediatric Gastroenterology
• Diagnostic Imaging
• Emergency Medicine

Background:

• Acute abdominal pain in children presents a diagnostic challenge due to diverse potential causes.
• Clinical presentation, physical examination, and laboratory results are crucial for directing diagnostic imaging strategies.

Purpose of the Study:

• To review the diagnostic approach for acute abdominal pain in children.
• To highlight the role of various imaging modalities in evaluating common and serious pediatric abdominal conditions.

Main Methods:

• Review of current literature on pediatric acute abdominal pain diagnosis.
• Emphasis on the utility of ultrasound and upper gastrointestinal series for specific conditions like intussusception and malrotation.
• Discussion of ultrasound's broad applicability in diagnosing appendicitis, cholecystitis, ovarian diseases, and other conditions.

Main Results:

• Ultrasound is effective for evaluating intussusception, appendicitis, cholecystitis, and ovarian pathology, potentially reducing inpatient observation.
• Upper gastrointestinal series is recommended for intestinal malrotation.
• Pelvic inflammatory disease is a key consideration in adolescent females with lower abdominal pain.

Conclusions:

• Clinical assessment effectively narrows differential diagnoses in pediatric acute abdominal pain, guiding imaging selection.
• Abdominal/pelvic ultrasound is the preferred initial imaging modality for many pediatric abdominal pain etiologies, often superseding computed tomography scans.