Summary
Paediatric abdominal pain is often a diagnostic dilemma. It is a common problem and, although the vast majority of these episodes are benign and self-limiting, persistent abdominal pain may signify an underlying pathology requiring urgent intervention. Timely assessment and intervention are critical in preventing untoward sequelae in children presenting with abdominal pain.
Because of the spectrum of aetiologies that manifest as abdominal pain, the differential remains broad and diagnosis can be challenging. In most cases, a thorough history and physical examination can narrow the broad differential. However, depending on the age of the child, additional investigations may be required to delineate diseases that present with similar symptoms. Furthermore, even with the assistance of parents or guardians, a comprehensive history is often difficult to obtain, and diagnosis therefore relies heavily on the clinical acumen of the practitioner.
Differential diagnosis
- Common
- Uncommon
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- Intussusception
- Meckel's diverticulum
- Mesenteric adenitis
- Hirschsprung's disease
- Ulcerative colitis
- Crohn's disease
- Small bowel obstruction
- Volvulus
- Large bowel obstruction
- Necrotising enterocolitis
- Peptic ulcer disease
- Viral hepatitis
- Biliary dyskinesia
- Acute pancreatitis
- Splenic infarction/cysts
- Nephrolithiasis
- Testicular torsion
- Ovarian torsion
- Ruptured ovarian cyst
- Pelvic inflammatory disease
- Pregnancy complications
- Empyema
