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Pediatric Abdominal Pain in Children Presenting to the Emergency Department

Wei Hao Lee1, Sharon O'Brien1, Dmitry Skarin1

  • 1From the Emergency Department, Princess Margaret Hospital for Children, Perth, Western Australia.

Pediatric Emergency Care
|March 15, 2019
PubMed

Insights

Pediatric abdominal pain in the emergency department (ED) often involves clinically significant abdominal pathology (CSAP), including appendicitis. This study highlights the health burden on families due to ongoing pain and missed school days.

Area of Science:

  • Pediatric Emergency Medicine
  • Gastroenterology
  • Clinical Epidemiology

Background:

  • Undifferentiated abdominal pain is a frequent reason for pediatric emergency department (ED) visits.
  • Accurate diagnosis and timely management are crucial for positive patient outcomes.

Purpose of the Study:

  • To determine the prevalence of clinically significant abdominal pathology (CSAP) and appendicitis in children presenting with abdominal pain.
  • To analyze diagnostic patterns, management strategies, and outcomes for pediatric abdominal pain cases in the ED.

Main Methods:

  • A prospective, multicenter observational cohort pilot study was conducted in 4 Australian EDs.
  • Children under 16 presenting with abdominal pain were enrolled over a 1-month period per site.
  • Data collected included demographics, investigations, treatments, length of stay, and follow-up outcomes.

Main Results:

  • Out of 555 presentations, 14.8% had CSAP, with appendicitis in 7.4%.
  • Less than half of patients underwent pathology tests (45.9%), and a third had imaging (31.2%) in the ED.
  • 50.5% reported ongoing pain post-discharge, and 13.1% missed over a week of school.

Conclusions:

  • The prevalence of CSAP and appendicitis was significant, indicating a notable disease burden.
  • Diagnostic test utilization in the ED was suboptimal, with fewer than half receiving blood tests and a third imaging.
  • Pediatric abdominal pain significantly impacts families through persistent symptoms and missed school days.
Abstract

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