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[Illness due to enterolith in children (author's transl)]
Insights
Rectal examination and abdominal palpation are crucial for diagnosing obscure abdominal pain, offering a simple, inexpensive method. This approach can prevent unnecessary X-rays and guide post-operative care, especially after appendectomy.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Diagnostic Procedures
Background:
- Obscure abdominal pain requires accurate diagnosis to prevent complications.
- Standard diagnostic procedures can be burdensome, particularly for children.
- Clinical classification is essential for effective patient management.
Observation:
- Rectal examination and abdominal palpation are simple, inexpensive diagnostic tools.
- These methods should precede extensive investigations like X-rays.
- Persistent pain after appendectomy indicates incomplete problem resolution.
Findings:
- Positive findings from rectal examination can obviate the need for X-rays.
- Failure to identify the cause of pain post-appendectomy requires re-evaluation.
- Enteroliths should be considered in differential diagnoses for abdominal pain.
Implications:
- Early and accurate diagnosis through physical examination can reduce healthcare costs and patient burden.
- Thorough clinical assessment prevents the progression to critical conditions such as ileus.
- Integrating rectal examination into routine diagnostics improves patient outcomes.
Abstract:
The aim of this paper is to emphasize the extreme importance of the rectal examination and exact palpation of the abdomen in cases of obscure abdominal pain, especially as it is purely a question of a simple and inexpensive diagnostical procedure. The rectal examination should always be carried out prior to any large scale diagnostical procedures as it does, in the care of positive findings, spare the child the considerable burden of X-rays. If, after an appendectomy, the same pains that led to the operation continue, one must conclude that their cause has not been removed by the operation. An exact clinical classification should be undertaken to avoid the later occurrence of a critical illness (ileus). As with any diagnosis, it is necessary in the event of enterolith too, to regard it as a possibility. The anamnestic registration of a daily bowel movement should not be a reason for not carrying out the rectal examinations as large quantities of stool can collect.