Download
acute abdominal pain in children n.
Skip this Video
Loading SlideShow in 5 Seconds..
Acute abdominal pain in children PowerPoint Presentation
Download Presentation
Acute abdominal pain in children

Acute abdominal pain in children

670 Views Download Presentation
Download Presentation

Acute abdominal pain in children

- - - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

  1. Acute abdominal pain in children

  2. Clinical features

  3. Diagnosis • Labs • Cbc not useful in undifferentiated abdominal pain • Obtain glucose in altered child • Urinalysis

  4. imaging • Abdominal plain films • intestinal obstruction (air fluid levels, dilated small/large bowel) • perforation (free air) • calcium-containing stones • Appendicolith • pneumatosis intestinalis (seen with NEC) • constipation (by degree of stool present)

  5. imaging • CT - appendicitis • US • Intussusception • ovarian pathology • testicular pathology • evaluation of the gallbladder for stones and inflammation • intrauterine pregnancy

  6. Pyloric stenosis • pyloric muscle hypertrophy that obstructs gastric outflow • Male, white race, first born, and a positive family history are risk factors • Presents during 2 and 8 weeks of life as nonbilious projectile vomiting • hyponatremic, hypokalemic, hypochloremic metabolic alkalosis • Diagnosed with ultrasound

  7. intussusception • portion of the alimentary tract telescopes into another segment • Obstruction of venous return, bowel ischemia, bloody stools • 6 – 18 month old with colicky abdominal pain • Plain films or US (best) • Air contrast enema both diagnostic and therapeutic

  8. Malrotation and volvulus • constant abdominal pain, bilious vomiting, abdominal distention, and irritability • Upper GI series: Bird’s beak appearance of duodenum • Tx: surgery

  9. appendicitis • Most common surgical emergency in children • Perforation rates approach 90% in children under 4 • vague, periumbilical pain that later localizes to the right side • Nausea, anorexia, and vomiting are seen in>80% of cases • Asking a child to hop is more sensitive than psoas, obturator or rovsing sign

  10. Diagnosis and treatment • Cbc is neither sensitive or specific • US or CT • Surgery • Unasyn for unperforated • Zosyn for perforated

  11. Necrotizing Enterocolitis • Intestinal necrosis in infants, most common premature • poor feeding, lethargy, abdominal distention, and tenderness • Leads to sepsis • Plain films are diagnostic • pneumatosis intestinalis (bubbles of air within the walls of the bowel) • NPO, IV fluids, antibiotics, and surgery

  12. Other causes • Non specific abdominal pain – number one • Colic • Gastroenteritis • Cholecystitis • Pancreatitis • Group A strep pharyngitis • constipation

  13. References • Tintinalli, Ch. 124