Aim:

Acute abdominal pain is a frequently encountered complaint of children seen in pediatric emergency medical services. Many cases of acute abdominal pain are benign, but some require rapid diagnosis and treatment to minimize morbidity. The aim of the present study was to investigate the role of history, physical examination, laboratory work-up and imaging studies in the diagnosis of acute abdominal pain in children.

Material and Methods:

The study population consisted of 200 consecutive children aged 5-17 years with acute abdominal pain. Demographic, clinical, laboratory and radiographic data were recorded in all patients.

Results:

Common medical causes of acute abdominal pain include upper respiratory tract infections (eg. acute pharyngitis, tonsillitis, sinusitis) and acute gastroenteritis. Although most children with acute abdominal pain have self-limited conditions, the pain may herald a surgical or medical emergency (eg, acute appendicitis, acute pyelonephritis, pneumonia, diabetic ketoacidosis). Surgical emergencies can be overlooked easily in children. The most common surgical cause of acute abdominal pain is acute appendicitis. Surgical consultation is necessary if a surgical cause is suspected or the cause is not obvious after a thorough evaluation. The etiology of abdominal pain can be diagnosed through the history and physical examination in most instances. Diaphoresis and vomiting were the most commonly associated symptoms in patients with acute abdominal pain. Signs of rigidity, marked abdominal tenderness, and rebound abdominal tenderness were more common in acute surgical abdomen than in medical conditions. The laboratory investigations and imaging studies are important in helping to come to a diagnosis. The most common pathologic laboratory finding was leukocytosis. The primary imaging of choice in abdominal emergencies in childhood is a radiograph of the abdomen, followed by ultrasound.

Conclusion:

The most frequent causes of acute abdominal pain are acute gastroenteritis and upper respiratory tract infections but acute abdomen, acute pyelonephritis, diabetic ketoacidosis and pneumonia should always be kept in mind so that appropriate medical or surgical intervention can be done without delay.

Keywords: Acute abdominal pain, pediatric emergency