Abdominal pain (peds): Difference between revisions

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== Background ==
== Background ==
 
*Bilious emesis is a surgical emergency until proven otherwise
*Bilious emesis is a surgical emergency until proven otherwise


== DDX ==
== DDX ==


{| cellspacing="1" cellpadding="3" border="0" bgcolor="#666666" width="100%"
{| class="FCK__ShowTableBorders" style="width: 394px; height: 762px" cellspacing="1" cellpadding="3" width="394" bgcolor="#666666" border="0"
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
! valign="top" bgcolor="#ffffff" align="left" rowspan="0" | Age
! valign="top" align="left" bgcolor="#ffffff" | Age  
! valign="top" bgcolor="#ffffff" align="left" rowspan="0" | Emergent
! valign="top" align="left" bgcolor="#ffffff" | Emergent  
! valign="top" bgcolor="#ffffff" align="left" rowspan="0" | Nonemergent
! valign="top" align="left" bgcolor="#ffffff" | Nonemergent
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" rowspan="7" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | 0–3 mo old
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" rowspan="7" | 0–3 mo old
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Necrotizing enterocolitis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Necrotizing enterocolitis
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Colic
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Colic
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Volvulus
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Volvulus
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Acute gastroenteritis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Acute gastroenteritis
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Testicular torsion
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Testicular torsion
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Constipation
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Constipation
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Incarcerated hernia
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Incarcerated hernia
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Trauma
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Trauma
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Toxic megacolon
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Toxic megacolon
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Tumor
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Tumor
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" rowspan="7" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | 3 mo–3 y old
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" rowspan="7" | 3 mo–3 y old
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Intussusception
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Intussusception
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Acute gastroenteritis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Acute gastroenteritis
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Testicular torsion
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Testicular torsion
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Constipation
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Constipation
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Trauma
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Trauma
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Urinary tract infections
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Urinary tract infections
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Volvulus
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Volvulus
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | HSP
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | HSP
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Appendicitis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Appendicitis
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Toxic megacolon
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Toxic megacolon
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Vaso-occlusive crisis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Vaso-occlusive crisis
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" rowspan="14" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | 3 y old–adolescence
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" rowspan="14" | 3 y old–adolescence
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Appendicitis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Appendicitis
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Constipation
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Constipation
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Diabetic ketoacidosis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Diabetic ketoacidosis
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Acute gastroenteritis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Acute gastroenteritis
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Vaso-occlusive crisis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Vaso-occlusive crisis
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Nonspecific viral syndromes
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Nonspecific viral syndromes
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Toxic ingestion
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Toxic ingestion
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | ''Streptococcus'' pharyngitis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | ''Streptococcus'' pharyngitis
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Testicular torsion
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Testicular torsion
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Urinary tract infections
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Urinary tract infections
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Ovarian torsion
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Ovarian torsion
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Pneumonia
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Pneumonia
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Ectopic pregnancy
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Ectopic pregnancy
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Pancreatitis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Pancreatitis
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Trauma
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Trauma
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Cholecystitis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Cholecystitis
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Toxic megacolon
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Toxic megacolon
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Renal stones
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Renal stones
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Tumor
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Tumor
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | HSP
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | HSP
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Inflammatory bowel disease
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Inflammatory bowel disease
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Gastric ulcer disease/gastritis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Gastric ulcer disease/gastritis
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Ovarian cyst
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Ovarian cyst
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px;" | Pregnancy
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Pregnancy
|}
|}


== Workup ==
== Workup ==
#UA, hCG
 
#Dehydration: Chemistry
#UA, hCG  
#Imaging
#Dehydration: Chemistry  
##Abd xray
#Imaging  
##Abd xray  
###Specific, not sensitive
###Specific, not sensitive
##Ultrasound
##Ultrasound  
###Appropriate for intussusception, ovarian/testicular, GB, IUP
###Appropriate for intussusception, ovarian/testicular, GB, IUP
##CT
##CT  
###May be a/w 1/1000 lifetime risk of malignancy
###May be a/w 1/1000 lifetime risk of malignancy


== See Also ==
== See Also ==
 
[[Necrotizing Enterocolitis (NEC)]]


[[Necrotizing Enterocolitis (NEC)]]
[[Volvulus]]  


[[Volvulus]]
[[Pyloric Stenosis]]  


[[Pyloric Stenosis]]
[[Intussusception]]  


[[Intussusception]]
[[Meckel's Diverticulum]]  


[[Meckel's Diverticulum]]
[[Appendicitis (Peds)]]  


[[Appendicitis (Peds)]]
[[Inguinal Hernia (Peds)]]  


[[Inguinal Hernia (Peds)]]
== Source  ==


== Source ==
Gausche 11/03- By Lampe  
Gausche 11/03- By Lampe


7/2/09 PANI
7/2/09 PANI  


[[Category:Peds]]  
[[Category:Peds]] [[Category:GI]]
[[Category:GI]]

Revision as of 05:38, 21 November 2011

Background

  • Bilious emesis is a surgical emergency until proven otherwise

DDX

Age Emergent Nonemergent
0–3 mo old Necrotizing enterocolitis Colic
Volvulus Acute gastroenteritis
Testicular torsion Constipation
Incarcerated hernia  
Trauma  
Toxic megacolon  
Tumor  
3 mo–3 y old Intussusception Acute gastroenteritis
Testicular torsion Constipation
Trauma Urinary tract infections
Volvulus HSP
Appendicitis  
Toxic megacolon  
Vaso-occlusive crisis  
3 y old–adolescence Appendicitis Constipation
Diabetic ketoacidosis Acute gastroenteritis
Vaso-occlusive crisis Nonspecific viral syndromes
Toxic ingestion Streptococcus pharyngitis
Testicular torsion Urinary tract infections
Ovarian torsion Pneumonia
Ectopic pregnancy Pancreatitis
Trauma Cholecystitis
Toxic megacolon Renal stones
Tumor HSP
  Inflammatory bowel disease
  Gastric ulcer disease/gastritis
  Ovarian cyst
  Pregnancy

Workup

  1. UA, hCG
  2. Dehydration: Chemistry
  3. Imaging
    1. Abd xray
      1. Specific, not sensitive
    2. Ultrasound
      1. Appropriate for intussusception, ovarian/testicular, GB, IUP
    3. CT
      1. May be a/w 1/1000 lifetime risk of malignancy

See Also

Necrotizing Enterocolitis (NEC)

Volvulus

Pyloric Stenosis

Intussusception

Meckel's Diverticulum

Appendicitis (Peds)

Inguinal Hernia (Peds)

Source

Gausche 11/03- By Lampe

7/2/09 PANI