Abdominal pain (peds): Difference between revisions
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''Depends on location and history'' | ''Depends on location and history'' | ||
*Consider: | *Consider: | ||
**[[Urinalysis]] | ** hCG | ||
***Do not forget to consider [[ectopic pregnancy]] in pre-teens in whom menarche has not yet occurred | |||
**[[Urinalysis]] | |||
**CBC | **CBC | ||
**Chemistry | **Chemistry | ||
Revision as of 15:28, 20 February 2017
For adult patients see Abdominal pain
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
- Do not forget to consider ectopic pregnancy in pre-teens in whom menarche has not yet occurred
- Urinalysis
- CBC
- Chemistry
- hCG
- Possible imaging:
- Ultrasound
- Appropriate for intussusception, ovarian/testicular, gallbladder, IUP, 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