Abdominal pain (peds): Difference between revisions
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**Chemistry | **Chemistry | ||
*Possible imaging: | *Possible imaging: | ||
**Ultrasound | **[[Ultrasound]] | ||
***Appropriate for [[intussusception]], ovarian/testicular, [[gallbladder]], | ***Appropriate for [[intussusception]], [[ovarian torsion|ovarian]]/[[testicular torsion]], [[gallbladder]], [[pregnancy]], [[Appendicitis (peds)|appendicitis]] | ||
**CT | **CT | ||
***May be associated with 1/1,000 lifetime risk of malignancy | ***May be associated with 1/1,000 lifetime risk of malignancy | ||
**[[Abdominal radiography]] | **[[Abdominal radiography]] | ||
***Abdominal plain xray films are specific, but not sensitive. As such, they have very little utility in the workup of pediatric abdominal pain, unless concerned for a [[Esophageal foreign body|foreign body]]. Do NOT use films to "confirm" a diagnosis of "constipation," as this is not specific and may also be found during surgical emergencies (e.g. [[appendicitis]]). | ***[[acute abdominal series|Abdominal plain xray]] films are specific, but not sensitive. As such, they have very little utility in the workup of pediatric abdominal pain, unless concerned for a [[Esophageal foreign body|foreign body]]. Do NOT use films to "confirm" a diagnosis of "constipation," as this is not specific and may also be found during surgical emergencies (e.g. [[appendicitis]]). | ||
==Management== | ==Management== | ||
Revision as of 19:54, 18 October 2019
For adult patients see Abdominal pain, abdominal pain in pregnancy, and/or abdominal pain (geriatrics)
Background
- Bilious emesis is a surgical emergency until proven otherwise
Clinical Features
- Abdominal pain
- May be associated with nausea, vomiting, or diarrhea
- Fever may be present in pain from infectious etiology
Differential Diagnosis
Pediatric Abdominal Pain
0–3 Months Old
- Emergent
- Nonemergent
3 mo–3 y old
- Emergent
- Nonemergent
3 y old–adolescence
- Emergent
- Nonemergent
Evaluation
Depends on location and history
- Consider:
- hCG
- Consider ectopic pregnancy in any female of reproductive age
- Urinalysis
- CBC
- Chemistry
- hCG
- Possible imaging:
- Ultrasound
- Appropriate for intussusception, ovarian/testicular torsion, gallbladder, pregnancy, appendicitis
- CT
- May be associated with 1/1,000 lifetime risk of malignancy
- Abdominal radiography
- Abdominal plain xray films are specific, but not sensitive. As such, they have very little utility in the workup of pediatric abdominal pain, unless concerned for a foreign body. Do NOT use films to "confirm" a diagnosis of "constipation," as this is not specific and may also be found during surgical emergencies (e.g. appendicitis).
- Ultrasound
Management
- Based on diagnosis
Disposition
- Depends on underlying etiology
- If symptoms are fully resolved and the patient has a benign abdominal exam, most patients go home with return precautions
- In general, unclear cases with continued pain should NOT be discharged home