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Acute Abdominal Pain in Children
1University of Missouri-Columbia, Columbia, MO, USA.
American Family Physician
|May 14, 2016
Summary
Acute abdominal pain in children often requires prompt diagnosis. Key indicators for surgical causes include fever and specific physical exam findings, guiding differential diagnosis by age group.
Area of Science:
- Pediatrics
- Gastroenterology
- Surgical Diagnosis
Background:
- Acute abdominal pain is a frequent reason for pediatric primary care visits.
- Identifying surgical causes requires careful assessment of symptoms and signs.
- Age-specific considerations are crucial for accurate differential diagnosis in children.
Purpose of the Study:
- To outline the diagnostic approach to acute abdominal pain in children.
- To highlight age-related differential diagnoses for pediatric abdominal pain.
- To review key investigations for identifying surgical abdominal pathology in pediatric patients.
Main Methods:
- Review of clinical presentation, including fever, vomiting, diarrhea, and abdominal findings.
- Age-stratified differential diagnosis for infants, toddlers, school-aged children, and adolescents.
- Discussion of laboratory tests (CBC, ESR/CRP, urinalysis, pregnancy test) and imaging modalities (radiography, ultrasonography, CT, MRI).
Main Results:
- Surgical red flags include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, guarding, rigidity, and rebound tenderness.
- Common pediatric surgical emergencies include malrotation, hernias, intussusception, and appendicitis.
- Appendicitis is the most frequent surgical cause of acute abdominal pain in adolescents.
Conclusions:
- Age-appropriate evaluation and targeted investigations are essential for managing acute abdominal pain in children.
- Ultrasonography is the preferred initial imaging for many pediatric abdominal conditions, with CT/MRI for inconclusive cases.
- Prompt diagnosis and surgical consultation are critical for conditions like appendicitis to prevent complications.
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