Related Experiment Videos
Insights
In children with acute abdominal pain, appendicitis is the most frequent diagnosis, but many cases remain undiagnosed. Sedation may aid diagnosis, unlike analgesia.
Area of Science:
- Pediatric Emergency Medicine
- Surgical Gastroenterology
Background:
- Acute abdominal pain is a common reason for pediatric emergency admissions.
- Distinguishing organic causes from non-specific pain is challenging in children.
Purpose of the Study:
- To analyze the causes and diagnostic challenges of acute abdominal pain in children admitted to the hospital.
- To evaluate the effectiveness of diagnostic aids and interventions.
Main Methods:
- Retrospective review of 416 children admitted with acute abdominal pain over twelve months.
- Analysis of diagnoses, surgical interventions, and diagnostic workups, including urinalysis.
Main Results:
- Appendicitis was the most common organic cause (31%).
- Constipation (9%) and urinary tract infections (7%) were other significant causes.
- A substantial proportion (45%) of children remained undiagnosed despite assessment.
- 46% of admitted children underwent surgery.
Conclusions:
- Appendicitis is the leading surgical cause of acute abdominal pain in children.
- A significant percentage of pediatric acute abdomen cases remain undiagnosed, highlighting diagnostic difficulties.
- Urinalysis is a useful, though not definitive, diagnostic tool.
- Sedation may be beneficial in diagnosing acute abdomen in children.
Abstract:
During a twelve-month period, 416 children with acute abdominal pain required emergency admission to Southampton General Hospital; 46% had operations. Appendicitis was the commonest organic cause of acute abdominal pain identified (31%). Constipation (9%) can present as acute abdominal pain simulating appendicitis. All children should have a urine sample examined microscopically and the finding of significant pyuria is suggestive, but not diagnostic, of a urinary tract infection (7%). Mesenteric adenitis, which can only be diagnosed with certainty at laparotomy, was less common (4%). Despite careful clinical assessment and follow up, 45% of children in this series remained undiagnosed. Sedation but not analgesia may assist in the diagnosis of the acute abdomen in children.