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Abdominal pain in children (Aetiology (Infection Resp: LL pneumonia …
Abdominal pain
in children
Definition
Pain sensation originating
from the abdomen
Epidemiology
Common
Any age
Multiple causes
Aetiology
Infection
Resp: LL pneumonia
GIT: appendicitis, peritonitis, pancreatitis,
hepatitis, Meckel's diverticula
GUT: UTI, pyelonephritis
Trauma
GIT obstruction: intissuception, volvulus
GUT: renal caliculi, hydronephrosis
Genital: torsion
Autoimmune
GIT: IBD, Coeliac
GUT: HSP
Metabolic
DKA
Porphyria
Idiopathic
GIT: constipation, IBS
Functional
Psychological (somatisation)
Drugs
Pb poisoning
Haematological
Sickle cell disease
Vascular
Abdominal migraine
Congenital/genetic
Hirschsprung's disease
Diagnosis
History
DH
Meds, allergies
FH
GIT disorders
PMH
Growth and development
Vaccinations
Known medical conditions
POH
Scans, bloods, growth, gestation,
delivery, weight, complications
PC/HPC
Abdo pain (SOCRATES)
Associates symptoms: N+V, haematemesis, bloating,
diarrhoea/constipation, malaena, fever, weight loss,
poor feeding, poor sleep, letharrgy/malaise
SH
Living arrangements, school/nursery,
social support, social services
Examination
Abdo exam
Pallor, dehydration,
distension,
Investigations
Bloods
Cap blood gas, FBC (anaemia, infection),
CRP/ESR (inflammation), U+E (renal), LFT (hepatic), TFT,
amylase (pancreatitis), glucose, ketones (DKA)
Blood cultures (infection)
Immune screen (Coeliac, ANA, ANCA)
Tox screen (Pb)
Urine
Dipstick, MCS (infection)
Bedside
Obs (fever, shock)
Measurements (weight loss)
BM (glucose, ketones)
Imaging
CXR (erect): pneumonia, perforation
Abdo USS/KUB:
AXR: volvulus, intussusception
Management
Initial ABCDE
Definitive
Per cause