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[The acute abdomen in children]

Till-Martin Theilen1, Udo Rolle2

  • 1Klinik für Kinderchirurgie und Kinderurologie, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.

Medizinische Klinik, Intensivmedizin Und Notfallmedizin
|June 9, 2023
PubMed

Insights

Acute abdomen in children requires prompt diagnosis to prevent organ loss or shock. Early evaluation of symptoms and medical history is crucial for timely treatment, though some conditions like PIMS-TS may not need surgery.

Area of Science:

  • Pediatric Emergency Medicine
  • Gastroenterology
  • Surgical Pediatrics

Context:

  • 8-10% of pediatric emergency room visits involve acute abdominal pain.
  • A systematic diagnostic approach is vital to exclude emergent conditions.
  • Acute abdomen in children presents a diagnostic challenge due to diverse etiologies.

Purpose:

  • To review the causes, clinical presentation, diagnostic strategies, and management of acute abdomen in pediatric patients.
  • To differentiate between surgical and non-surgical causes of acute abdomen.
  • To highlight emerging conditions like PIMS-TS and their impact on treatment paradigms.

Summary:

  • Causes include inflammation, ischemia, obstruction, bleeding, and referred pain from extra-abdominal sources.
  • Key symptoms are abdominal pain, vomiting, guarding, and signs of systemic compromise (tachycardia, tachypnea, shock).
  • While emergent surgery is often indicated, conditions such as pediatric inflammatory multisystem syndrome temporarily associated with SARS-CoV-2 infection (PIMS-TS) may require conservative management.

Impact:

  • Timely diagnosis and intervention can prevent irreversible organ damage and life-threatening complications.
  • A thorough history and physical examination are paramount for accurate diagnosis.
  • Understanding the varied presentations ensures appropriate and timely patient care, improving outcomes.
Abstract

Keywords:
Abdominal painEmergenciesPeritonitisSARS-CoV‑2Sepsis

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