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[Recurrent abdominal pain. A prospective study of 68 children]
K Oymar1, G Fluge, K Rosendahl
1Barneklinikken, Haukeland Sykehus, Bergen.
Insights
Recurrent abdominal pain in children often resolves without invasive tests. A standard investigation approach is recommended, with advanced imaging like abdominal ultrasound reserved for specific concerns, leading to significant pain improvement in most cases.
Area of Science:
- Pediatric Gastroenterology
- Clinical Investigation
Context:
- Recurrent abdominal pain (RAP) is a common pediatric complaint.
- Standard diagnostic protocols are often employed for children with RAP.
Purpose:
- To evaluate the diagnostic yield of standard investigations and abdominal ultrasound in children with recurrent abdominal pain.
- To assess the long-term outcomes of children with recurrent abdominal pain.
Summary:
- A prospective study followed 68 children with recurrent abdominal pain (RAP).
- Organic disease was identified in only 12% of cases, suggesting most RAP is functional.
- Abdominal ultrasound was deemed useful only when specific organic disease was suspected.
- At follow-up, 85% of children experienced pain improvement or resolution.
Impact:
- Highlights the low incidence of organic disease in pediatric recurrent abdominal pain.
- Recommends a judicious approach to investigations, reserving advanced imaging for specific indications.
- Provides evidence supporting conservative management strategies for most children with RAP.
- Informs clinical practice guidelines for the investigation and management of pediatric recurrent abdominal pain.
Abstract:
We followed 68 children with recurrent abdominal pain in a prospective study including a standard investigation programme and abdominal ultrasound. We found an organic disease which explained the pain in eight patients (12%). Most children with recurrent abdominal pain can be dealt with by a general practitioner. In our opinion, further investigation, including abdominal ultrasound should only be carried out in the event of specific suspicion of organic disease. At follow-up 16-34 months later, 55 children (85%) had improved or were free of pain. We discuss the differential diagnoses and propose a plan of investigation for these children.