Belly pain is a very common Paediatric ED presentation, so how do we sort the plain old tummy-ache from the more serious causes? Common conditions like gastroenteritis and constipation can mimic more significant diagnoses such as appendicitis and intussusception.
In this PEMcast we take a quick tour through the causes of abdominal pain in children.
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Outline: Abdominal Pain in Children
[CP] hello, disclaimer, introduction/background
Approach & Differentials
(with reference to McCollough & Sharieff 2006, and our own experience):
[KB] Approach to assessment
[SF] Extra-abdominal causes of belly pain:
- pharyngitis / URTI = mesenteric adenitis
- spider bite (probably not Red Back Spider)
- ingestions eg iron
- abdominal migraine
- abdominal epilepsy ??
- torsion testis / ovary
Tsalkidis A, Gardikis S, Cassimos D, Kambouri K, Tsalkidou E, Deftereos S, Chatzimichael A. Acute abdomen in children due to extra-abdominal causes. Pediatr Int. 2008 Jun;50(3):315-8. PubMed PMID: 18533944.
Causes of Abdominal Pain in Children
[CP] Main concern for parents and doctors is appendicitis (difficult diagnosis, medicolegal concerns, signifcant morbidity, high rate of perforation in younger children)
Other causes: (brief sketch of each):
[CP] Mesenteric adenitis
[KB] Functional & recurrent Abdo pain
[SF] Abdominal Migraine
[KB] Bowel Obstruction & incarcerated hernia
[SF] Meckel’s diverticulitis
[CP] Infants: “Colic”
(Pyloric spenosis, malrotation with midgut volvulus, NEC) – pain is not the predominant symptom
[ALL] Comments on abdo pain differentials, colic, infants & neonates
[CP] Summary, goodbye