Acute Abdominal Pain in Children

CLINICAL DIAGNOSTIC MANUAL

Acute abdominal pain in children is a common complaint and one of the most frequent reasons for paediatric consultations and emergency visits. It can be caused by a variety of conditions ranging from benign to potentially life-threatening.

Proper evaluation of abdominal pain in children requires a detailed medical history, a thorough physical examination, and often, additional tests to identify the underlying cause. It is crucial to differentiate between self-limiting causes and those that require urgent intervention.

Pathology	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Gastroenteritis	Diffuse abdominal pain, diarrhoea, vomiting, fever, dehydration	History of exposure, gastrointestinal symptoms	Stool culture, rotavirus and norovirus tests
Infant colic	Inconsolable crying, leg flexion over the abdomen, evening crying episodes	Clinical history, typical symptoms	Clinical diagnosis, exclusion of other causes
Mesenteric adenitis	Right lower quadrant abdominal pain, fever, nausea, vomiting	History of recent infection, physical examination	Abdominal ultrasound, blood tests
Urinary tract infection	Abdominal pain, dysuria, fever, urinary urgency, haematuria	History of urinary symptoms, physical examination	Urinalysis, urine culture
Intussusception	Intermittent abdominal pain, vomiting, “currant jelly” stools, palpable abdominal mass	History of episodes of pain and vomiting, physical examination	Abdominal ultrasound, barium enema
Acute appendicitis	Right lower quadrant abdominal pain, fever, anorexia, nausea, vomiting	History of migratory pain, physical examination	Abdominal ultrasound, computed tomography (CT)
Other causes	Symptoms vary depending on underlying pathology, may include fever, nausea, vomiting	Medical history, physical examination	Specific tests based on clinical suspicion