Abdominal pain (peds): Difference between revisions
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{{Peds top}} [[abdominal pain]], [[abdominal pain in pregnancy]], and/or [[abdominal pain (geriatrics)]] | <languages/> | ||
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<translate> [[Special:MyLanguage/abdominal pain|abdominal pain]], [[Special:MyLanguage/abdominal pain in pregnancy|abdominal pain in pregnancy]], and/or [[Special:MyLanguage/abdominal pain (geriatrics)|abdominal pain (geriatrics)]] | |||
==Background== | ==Background== | ||
*Bilious emesis is a surgical emergency until proven otherwise | *Bilious emesis is a surgical emergency until proven otherwise | ||
==Clinical Features== | ==Clinical Features== | ||
[[File:Abdominal Quadrant Regions.jpg|thumb|Side-by-side comparison of quadrants and regions.]] | [[File:Abdominal Quadrant Regions.jpg|thumb|Side-by-side comparison of quadrants and regions.]] | ||
[[File:1506 Referred Pain Chart.jpg|thumb|Chart of commonly reported referred pain sites.]] | [[File:1506 Referred Pain Chart.jpg|thumb|Chart of commonly reported referred pain sites.]] | ||
*Abdominal pain | *Abdominal pain | ||
*May be associated with [[nausea]], [[vomiting]], or [[diarrhea]] | *May be associated with [[Special:MyLanguage/nausea|nausea]], [[Special:MyLanguage/vomiting|vomiting]], or [[Special:MyLanguage/diarrhea|diarrhea]] | ||
*[[Fever]] may be present in pain from infectious etiology | *[[Special:MyLanguage/Fever|Fever]] may be present in pain from infectious etiology | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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{{Pediatric abdominal pain DDX}} | {{Pediatric abdominal pain DDX}} | ||
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==Evaluation== | ==Evaluation== | ||
''Depends on location and history'' | ''Depends on location and history'' | ||
*Consider: | *Consider: | ||
**hCG | **hCG | ||
***Consider [[ectopic pregnancy]] in any female of reproductive age | ***Consider [[Special:MyLanguage/ectopic pregnancy|ectopic pregnancy]] in any female of reproductive age | ||
**[[Urinalysis]] | **[[Special:MyLanguage/Urinalysis|Urinalysis]] | ||
**CBC | **CBC | ||
**Chemistry | **Chemistry | ||
*Possible imaging: | *Possible imaging: | ||
**[[Ultrasound]] | **[[Special:MyLanguage/Ultrasound|Ultrasound]] | ||
***Appropriate for [[intussusception]], [[ovarian torsion|ovarian]]/[[testicular torsion]], [[gallbladder]], [[pregnancy]], [[Appendicitis (peds)|appendicitis]] | ***Appropriate for [[Special:MyLanguage/intussusception|intussusception]], [[Special:MyLanguage/ovarian torsion|ovarian]]/[[Special:MyLanguage/testicular torsion|testicular torsion]], [[Special:MyLanguage/gallbladder|gallbladder]], [[Special:MyLanguage/pregnancy|pregnancy]], [[Special:MyLanguage/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]] | **[[Special:MyLanguage/Abdominal radiography|Abdominal radiography]] | ||
***[[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]]). | ***[[Special:MyLanguage/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 [[Special:MyLanguage/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. [[Special:MyLanguage/appendicitis|appendicitis]]). | ||
==Management== | ==Management== | ||
*Based on diagnosis | *Based on diagnosis | ||
==Disposition== | ==Disposition== | ||
*Depends on underlying etiology | *Depends on underlying etiology | ||
**If symptoms are fully resolved and the patient has a benign abdominal exam, most patients go home with return precautions | **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 | **In general, unclear cases with continued pain should NOT be discharged home | ||
==See Also== | ==See Also== | ||
*[[Abdominal Pain]] | |||
*[[Pyloric Stenosis]] | *[[Special:MyLanguage/Abdominal Pain|Abdominal Pain]] | ||
*[[Meckel's Diverticulum]] | *[[Special:MyLanguage/Pyloric Stenosis|Pyloric Stenosis]] | ||
*[[Inguinal Hernia (Peds)]] | *[[Special:MyLanguage/Meckel's Diverticulum|Meckel's Diverticulum]] | ||
*[[Special:MyLanguage/Inguinal Hernia (Peds)|Inguinal Hernia (Peds)]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
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[[Category:GI]] | [[Category:GI]] | ||
[[Category:Symptoms]] | [[Category:Symptoms]] | ||
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Revision as of 21:31, 4 January 2026
This page is for pediatric patients. 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
See Also