Possible causes for a child’s abdominal pain range from trivial to life-threatening, with little difference in the child’s complaints. Fortunately, abdominal pain in a child usually improves quickly. Each parent or caregiver faces the difficulty deciding whether a complaint needs emergency care or not.
Abdominal pain is a common problem in children. Although most children with acute abdominal pain have self-limited conditions, the pain may herald a surgical or medical emergency.
Causes to be kept in MindAlthough many cases of acute abdominal pain are benign, some require rapid diagnosis and treatment to minimize morbidity. Numerous disorders can cause abdominal pain. The most common medical cause is gastroenteritis, and the most common surgical cause is appendicitis.
In the acute surgical abdomen, pain generally precedes vomiting, while the reverse is true in medical conditions. Diarrhea often is associated with gastroenteritis or food poisoning. Appendicitis should be suspected in any child with pain in the right lower quadrant. Signs that suggest an acute surgical abdomen include involuntary guarding or rigidity, marked abdominal distention, marked abdominal tenderness, and rebound abdominal tenderness.
The list that should be in mind while evaluating a child with abdominal is is as follows:
Medical causes
In a child presenting with acute abdominal pain a complete history and detailed physical examination is important to reach a proper diagnosis and then appropriate management
Appearance of the child: As a general rule, if the child looks very ill in addition to being in pain, medical help should be sought. Often, the caregiver “just knows” the child is very sick. Key things to look for when abdominal pain occurs include pale appearance, sweating, or a child who is sleepy or listless. It is most concerning when a child cannot be distracted from the pain with play, or refuses to drink or eat for several hours.
Vomiting: Children vomit quite frequently with abdominal pain, but vomiting does not always indicate a serious problem. In infants and very young children, vomiting that is green or yellow is a reason to call the doctor. At any age, vomiting that appears to contain blood or darker material is a reason to seek emergency care.
Diarrhea: This is also very common with abdominal pain and usually indicates that a virus is the cause.
Fever: The presence of fever does not always indicate a serious problem. Indeed, a normal temperature can be seen with the more serious causes of abdominal pain.
Urinary problems: Abdominal pain associated with any trouble urinating, such as painful or frequent urination, could indicate an infection and is a reason to seek medical care.
Rash: Certain serious causes of abdominal pain also occur with a new rash. The combination of skin rash with abdominal pain is a reason to contact your doctor.
Abdominal Examination
The breathing pattern should be observed, and the patient should be asked to distend the abdomen and then flatten it. After the child is asked to indicate, with one finger, the area of maximal tenderness, the abdomen should be gently palpated, moving toward (but not palpating) that area. The physician should examine for Rovsing’s sign (when pressure on the left lower quadrant distends the column of colonic gas, causing pain in the right lower quadrant at the site of appendiceal inflammation), then gently assess muscle rigidity. Gentle percussion best elicits rebound tenderness. Deeper palpation is necessary to discover masses and organomegaly.
Investigations
Laboratory studies should be tailored to the patient’s symptoms and clinical findings. Initial laboratory studies may include a complete blood cell count and urinalysis.
Plain-film abdominal radiographs are most useful when intestinal obstruction or perforation of a viscus in the abdomen is a concern.
Chest radiographs may help rule out pneumonia.
CT likely is more accurate than ultrasonography.
Treatment
Conservative Management
Rest: A child with active abdominal pain often will benefit from resting.
Diet and Fluids: Proper nutritional care is necessary.Dehydration takes time to develop, so forcing fluids is not always necessary. A child who is actively vomiting will not be able to hold down a large amount of liquid. Avoid milk, fruit juices, heavily carbonated beverages, coffee, and sports drinks in patients with diarrhea, since the stomach may not tolerate these fluids. Start solid food – first try toast or crackers – then advance to regular foods as they tolerate the feedings. Banana, apple sauce, or cooked rice are also suitable foods for introduction .
Medical Treatment
Treatment will be prescribed according to the history, physical examination, test results, and the individual child. Treatment may be as simple as sending the child home with instructions for rest, encouraging fluids, and eating a bland diet. For serious conditions, treatment can be as extensive as hospital admission and surgery.
Need for Surgical Consultation
Traditionally, the use of analgesics is discouraged in patients with abdominal pain for fear of interfering with accurate evaluation and diagnosis. However, several prospective, randomized studies have shown that judicious use of analgesics actually may enhance diagnostic accuracy by permitting detailed examination of a more cooperative patient.
- Diabetic ketoacidosis
- Inflammatory bowel disease
- Acute adrenal failure
- Gastroenteritis
- Food Poisioning
- Urinary tract infection
- Hepatitis
- Sickle cell crisis
- Henoch-Schönlein purpura
- Acute appendicitis
- Bowel obstruction
- Intussusception/ volvulus
- Testicular torsion
- Meckel’s diverticulum
- Infantile colic
- Functional pain
In a child presenting with acute abdominal pain a complete history and detailed physical examination is important to reach a proper diagnosis and then appropriate management
Appearance of the child: As a general rule, if the child looks very ill in addition to being in pain, medical help should be sought. Often, the caregiver “just knows” the child is very sick. Key things to look for when abdominal pain occurs include pale appearance, sweating, or a child who is sleepy or listless. It is most concerning when a child cannot be distracted from the pain with play, or refuses to drink or eat for several hours.
Vomiting: Children vomit quite frequently with abdominal pain, but vomiting does not always indicate a serious problem. In infants and very young children, vomiting that is green or yellow is a reason to call the doctor. At any age, vomiting that appears to contain blood or darker material is a reason to seek emergency care.
Diarrhea: This is also very common with abdominal pain and usually indicates that a virus is the cause.
Fever: The presence of fever does not always indicate a serious problem. Indeed, a normal temperature can be seen with the more serious causes of abdominal pain.
Urinary problems: Abdominal pain associated with any trouble urinating, such as painful or frequent urination, could indicate an infection and is a reason to seek medical care.
Rash: Certain serious causes of abdominal pain also occur with a new rash. The combination of skin rash with abdominal pain is a reason to contact your doctor.
Abdominal Examination
The breathing pattern should be observed, and the patient should be asked to distend the abdomen and then flatten it. After the child is asked to indicate, with one finger, the area of maximal tenderness, the abdomen should be gently palpated, moving toward (but not palpating) that area. The physician should examine for Rovsing’s sign (when pressure on the left lower quadrant distends the column of colonic gas, causing pain in the right lower quadrant at the site of appendiceal inflammation), then gently assess muscle rigidity. Gentle percussion best elicits rebound tenderness. Deeper palpation is necessary to discover masses and organomegaly.
Investigations
Laboratory studies should be tailored to the patient’s symptoms and clinical findings. Initial laboratory studies may include a complete blood cell count and urinalysis.
Plain-film abdominal radiographs are most useful when intestinal obstruction or perforation of a viscus in the abdomen is a concern.
Chest radiographs may help rule out pneumonia.
CT likely is more accurate than ultrasonography.
Treatment
Conservative Management
Rest: A child with active abdominal pain often will benefit from resting.
Diet and Fluids: Proper nutritional care is necessary.Dehydration takes time to develop, so forcing fluids is not always necessary. A child who is actively vomiting will not be able to hold down a large amount of liquid. Avoid milk, fruit juices, heavily carbonated beverages, coffee, and sports drinks in patients with diarrhea, since the stomach may not tolerate these fluids. Start solid food – first try toast or crackers – then advance to regular foods as they tolerate the feedings. Banana, apple sauce, or cooked rice are also suitable foods for introduction .
Medical Treatment
Treatment will be prescribed according to the history, physical examination, test results, and the individual child. Treatment may be as simple as sending the child home with instructions for rest, encouraging fluids, and eating a bland diet. For serious conditions, treatment can be as extensive as hospital admission and surgery.
Need for Surgical Consultation
- Severe or increasing abdominal pain with progressive signs of deterioration.
- Bile-stained or feculent vomitus.
- Involuntary abdominal guarding/rigidity.
- Rebound abdominal tenderness.
- Marked abdominal distension with diffuse tympany.
- Signs of acute fluid or blood loss into the abdomen.
- Significant abdominal trauma.
- Suspected surgical cause for the pain.
- Abdominal pain without an obvious etiology.
Traditionally, the use of analgesics is discouraged in patients with abdominal pain for fear of interfering with accurate evaluation and diagnosis. However, several prospective, randomized studies have shown that judicious use of analgesics actually may enhance diagnostic accuracy by permitting detailed examination of a more cooperative patient.
I'm 15 years old. I was born with HIV my mother passed away because of the HIV infection And I regret why i never met Dr Itua he could have cured my mum for me because as a single mother it was very hard for my mother I came across Dr itua healing words online about how he cure different disease in different races diseases like HIV/Aids Herpes,Parkison,Asthma,Autism,Copd,Epilepsy,Shingles,Cold Sore,Infertility, Chronic Fatigues Syndrome,Fibromyalgia,Love Spell,Prostate Cancer,Lung Cancer,Glaucoma.,psoriasis, Cataracts,Macular degeneration,Cardiovascular disease,Lung disease.Enlarged prostate,Osteoporosis.Alzheimer's disease,psoriasis,
ReplyDeleteDementia.,Tach Disease,Breast Cancer,Blood Cancer,Colo-Rectal Cancer,Love Spell,Chronic Diarrhea,Ataxia,Arthritis,Amyotrophic Lateral Scoliosis,Fibromyalgia,Fluoroquinolone Toxicity
Syndrome Fibrodysplasia Ossificans ProgresSclerosis,Weak Erection,Breast Enlargment,Penis Enlargment,Hpv,measles, tetanus, whooping cough, tuberculosis, polio and diphtheria)Diabetes Hepatitis even Cancer I was so excited but frighten at same time because I haven't come across such thing article online then I contacted Dr Itua on Mail drituaherbalcenter@gmail.com/ . I also chat with him on what's app +2348149277967 he tells me how it works then I tell him I want to proceed I paid him so swiftly Colorado post office I receive my herbal medicine within 4/5 working days he gave me guild lines to follow and here am I living healthy again can imagine how god use men to manifest his works am I writing in all articles online to spread the god work of Dr Itua Herbal Medicine,He's a Great Man.