Abdomen Pain in Children
Have a low threshold for imaging and/or consultation, especially in preverbal children - Dr. Tim Horeczko
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Evaluation of abdominal pain in children
A comprehensive differential diagnosis of abdominal pain in children of all ages can be soporific even for the insomniac. In this section we discuss a short list of critical diagnoses that should be considered. A comprehensive list is so ponderous as to be practically useless for an ED evaluation.
The diagnoses of most concern are those that require operative intervention. The three most common surgical conditions are appendicitis, incarcerated inguinal hernia, and intussusception.
When developing a differential diagnosis, consider the child's age. For example, intussusception is most commonly seen in children between 4 and 10 months of age, but almost never in adolescents.
Although…
Resources
The Pediatric Surgical Abdomen
Abdominal pain is common; so are strongly held myths and legends about what is concerning, and what is not.
Abdominal Pain & Vomiting
Abdominal pain can be divided in to three types somatic, visceral, and referred.
Approach to Pediatric Abdominal Pain in the ED: Part I
In the approach to pediatric abdominal pain, certain entities are more common in different age groups; an age-based differential diagnosis of abdominal pain... In the neonate with abdominal pain, always consider necrotizing enterocolitis, malrotation with midgut volvulus, Hirschsprung’s disease, pyloric stenosis, and neonatal testicular torsion.
Pearls & Pitfalls: Pediatric Abdominal Pain Misdiagnosed
So, when you are evaluating abdominal pain, have a practical differential diagnoses list. Sure, hyperthyroidism, lead poisoning, Addison's disease, pancreatitis, porphyria, and abdominal migraine may be a cause of pediatric abdominal pain, but when was the last time you diagnosed one of these conditions?
Pediatric Abdominal Pain An Emergency Medicine Perspective
Pediatric abdominal pain is a common complaint evaluated in emergency departments (EDs). Although often due to benign causes, the varied and nonspecific presentations present a diagnostic challenge.
Pediatric Abdominal Pain and Appendicitis
The equivalent of ‘jump tenderness’ in infants and toddlers is having the caregiver bounce the child on their knee and observing for irritability.
Evaluation of abdominal pain in children
Evaluation of pediatric abdominal pain can prove a diagnostic challenge. Children may be limited in their ability to give an accurate history. Parents or guardians may also have difficulty interpreting the complaints of small children. In many cases, the causes are benign with few long-term sequelae. However, some require rapid diagnosis and treatment in order to prevent significant morbidity or mortality. Consideration of the child's age helps narrow the differential diagnoses.
#EM3
Be able to examine and recognise the cause of acute abdominal pain in all age groups.
Meckel’s diverticulum
Point-of-care ultrasound can be used to detect Meckel’s diverticulum as the underlying etiology of lower abdominal pain in pediatric patients.
Pediatric Surgery Library
Acute abdominal pain in children is one of the more frequent reasons for emergency room visits and pediatric surgical consultations.
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