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Title: ABDOMINAL PAIN IN CHILDREN
Description: Have you ever wondered why recurrent complaint of "Tommy pain" in children? What are the causes? What is the solution?

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By

Dr IHEJI CHUKWUNONSO





Abdominal pain in a child is one of the most
common presentations with both trivial and
life threatening etiologies, ranging from
functional pains to serious organic problems
...






Diagnosing abdominal pain in children is also
a challenging task
...

volvulus in neonates, intussusception in
toddlers) and trying to thoroughly evaluate a
child in pain can make the process all the
more challenging
...












Varying age groups
Gender
Overall stranger anxiety
Caregiver anxiety/idiosyncrasy
Inadequate knowledge of the physician
Ignorance
Poverty
Late presentation

Acute or chronic (Could be recurrent)
 Medical and surgical
 Based on system
 Based on age groups: More relevant to
paediatricians


















Gastrointestinal:
Gastroenteritis
Appendicitis
Mesenteritic
lymphadenitis
Constipation
PUD
IBD
Peritonitis
Abd Trauma
Intussusception
Volvolus
Incarcerated Hernia,
ETC











GUS
UTI
Calculi
Dysmenorrhea
Mittleschmerz
PID
Threatned abortion
Ectopic Preg
Testicular/ Ovarian
Torsion, etc











Liver, Spleen,
Pancreas & Biliary
Tract
Hepatitis
Cholecystitis
Cholelithiasis
Splenic infarction
Ruptured spleen
Pancreatitis

Metabolic
 DKA
 Hypoglycaemia
 Acute renal
insufficiency
 Haematological
 SCD
 HUS
 Respiratory System
 Pneumonia
 Diaphragmatic
pleurisy


 Drugs

and toxins
 Erythromycin
 Salicylates
 Pb poisoning
 Venoms
 Miscellaneous
 Infantile colic
 Pharyngitis
 Angioneurotic
edema

 Tumours


Neuroblastomas,
??wilms














<1yr
Infantile colic
Gastroenteritis
Constipation
UTI
Intussusception
Volvolus
Hirschsprung’s dx
Incarcerated hernia
Typhoid enteritis















>1-5yrs
Gastroenteritis
Appendicitis
Constipation
UTI
Intussusception
Volvolus
Trauma
Pharyngitis
SC crisis
Typhoid enteritis














>5 – 11yrs
Gastroenteritis
Typhoid fever
Appendicitis
Constipation
UTI
Trauma
Pharyngitis
Pneumonia
SC crisis
Functional pain














>11 – 18yrs
Appendicitis
Gastroenteritis
Typhoid fever
Constipation
Dysmenorrhea
Mittleschmerz
PID
Threatened abortion
Ectopic pregnancy
Ovarian/testicular
torsion

 Detailed

history
 Thorough examination
 Relevant investigations
 Appropriate treatment









Note PQRSTAAA

Place/Location: identify the specific location
of the pain, have child use one finger to
locate her pain
...
e
...
e
...


Associated Symptoms

Relevance

Diarrhea

Gastroenteritis, IBD

vomiting

Gastroenteritis, Appendicitis, Pyloric
stenosis,etc

Bloody stool

UGIB/LGIB, Ulcerative colitis, NEC, dysentry,
constipation

Hematemesis

UGIB, PUD, Gastritis

Bilious emesis

Small bowel obstruction

Jaundice

Hepatitis, or biliary tree obstruction, SCD

Joint pain/swelling

IBD, HSP, SCD

Skin lesion

IBD, HSP, liver dx

Testicular pain

Testicular torsion, orchitis

Dysuria,
polyuria/haematuria

UTI, pyelonephritis

Vaginal/Penile Discharge

STI

Dysmenorr
Title: ABDOMINAL PAIN IN CHILDREN
Description: Have you ever wondered why recurrent complaint of "Tommy pain" in children? What are the causes? What is the solution?