Abdominal pain in children: Difference between revisions

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|Appendicitis<ref name="pmid26015876">{{cite journal |vauthors=Marzuillo P, Germani C, Krauss BS, Barbi E |title=Appendicitis in children less than five years old: A challenge for the general practitioner |journal=World J Clin Pediatr |volume=4 |issue=2 |pages=19–24 |date=May 2015 |pmid=26015876 |pmc=4438437 |doi=10.5409/wjcp.v4.i2.19 |url=}}</ref>, Gastrointestinal reflux disease<ref name="pmid8820774">{{cite journal |vauthors=Moir CR |title=Abdominal pain in infants and children |journal=Mayo Clin Proc |volume=71 |issue=10 |pages=984–9, quiz 989 |date=October 1996 |pmid=8820774 |doi=10.1016/S0025-6196(11)63773-7 |url=}}</ref>, constipation <ref name="pmid8820774">{{cite journal |vauthors=Moir CR |title=Abdominal pain in infants and children |journal=Mayo Clin Proc |volume=71 |issue=10 |pages=984–9, quiz 989 |date=October 1996 |pmid=8820774 |doi=10.1016/S0025-6196(11)63773-7 |url=}}</ref>,irritable bowel syndrome<ref name="pmid29881232">{{cite journal |vauthors=Devanarayana NM, Rajindrajith S |title=Irritable bowel syndrome in children: Current knowledge, challenges and opportunities |journal=World J Gastroenterol |volume=24 |issue=21 |pages=2211–2235 |date=June 2018 |pmid=29881232 |pmc=5989237 |doi=10.3748/wjg.v24.i21.2211 |url=}}</ref>, celiac disease <ref name="pmid20301720">{{cite journal |vauthors=Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Mirzaa G, Amemiya A, Taylor AK, Lebwohl B, Snyder CL, Green PHR |title= |journal= |volume= |issue= |pages= |date= |pmid=20301720 |doi= |url=}}</ref>,Meckel's  divreticulum<ref name="pmid31294008">{{cite journal |vauthors=Keese D, Rolle U, Gfroerer S, Fiegel H |title=Symptomatic Meckel's Diverticulum in Pediatric Patients-Case Reports and Systematic Review of the Literature |journal=Front Pediatr |volume=7 |issue= |pages=267 |date=2019 |pmid=31294008 |pmc=6606722 |doi=10.3389/fped.2019.00267 |url=}}</ref>, Intussusception<ref name="pmid30806357">{{cite journal |vauthors=Simon NM, Joseph J, Philip RR, Sukumaran TU, Philip R |title=Intussusception: Single Center Experience of 10 Years |journal=Indian Pediatr |volume=56 |issue=1 |pages=29–32 |date=January 2019 |pmid=30806357 |doi= |url=}}</ref>
|Appendicitis<ref name="pmid26015876">{{cite journal |vauthors=Marzuillo P, Germani C, Krauss BS, Barbi E |title=Appendicitis in children less than five years old: A challenge for the general practitioner |journal=World J Clin Pediatr |volume=4 |issue=2 |pages=19–24 |date=May 2015 |pmid=26015876 |pmc=4438437 |doi=10.5409/wjcp.v4.i2.19 |url=}}</ref>, Gastrointestinal reflux disease<ref name="pmid8820774">{{cite journal |vauthors=Moir CR |title=Abdominal pain in infants and children |journal=Mayo Clin Proc |volume=71 |issue=10 |pages=984–9, quiz 989 |date=October 1996 |pmid=8820774 |doi=10.1016/S0025-6196(11)63773-7 |url=}}</ref>, constipation <ref name="pmid8820774">{{cite journal |vauthors=Moir CR |title=Abdominal pain in infants and children |journal=Mayo Clin Proc |volume=71 |issue=10 |pages=984–9, quiz 989 |date=October 1996 |pmid=8820774 |doi=10.1016/S0025-6196(11)63773-7 |url=}}</ref>,irritable bowel syndrome<ref name="pmid29881232">{{cite journal |vauthors=Devanarayana NM, Rajindrajith S |title=Irritable bowel syndrome in children: Current knowledge, challenges and opportunities |journal=World J Gastroenterol |volume=24 |issue=21 |pages=2211–2235 |date=June 2018 |pmid=29881232 |pmc=5989237 |doi=10.3748/wjg.v24.i21.2211 |url=}}</ref>, celiac disease <ref name="pmid20301720">{{cite journal |vauthors=Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Mirzaa G, Amemiya A, Taylor AK, Lebwohl B, Snyder CL, Green PHR |title= |journal= |volume= |issue= |pages= |date= |pmid=20301720 |doi= |url=}}</ref>,Meckel's  divreticulum<ref name="pmid31294008">{{cite journal |vauthors=Keese D, Rolle U, Gfroerer S, Fiegel H |title=Symptomatic Meckel's Diverticulum in Pediatric Patients-Case Reports and Systematic Review of the Literature |journal=Front Pediatr |volume=7 |issue= |pages=267 |date=2019 |pmid=31294008 |pmc=6606722 |doi=10.3389/fped.2019.00267 |url=}}</ref>, Intussusception<ref name="pmid30806357">{{cite journal |vauthors=Simon NM, Joseph J, Philip RR, Sukumaran TU, Philip R |title=Intussusception: Single Center Experience of 10 Years |journal=Indian Pediatr |volume=56 |issue=1 |pages=29–32 |date=January 2019 |pmid=30806357 |doi= |url=}}</ref>, Volvulus<ref name="pmid28722866">{{cite journal |vauthors=Le CK, Nahirniak P, Anand S, Cooper W |title= |journal= |volume= |issue= |pages= |date= |pmid=28722866 |doi= |url=}}</ref>.
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|Genitourinary
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Revision as of 17:16, 3 March 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Synonyms and keywords: Abdominal pain in kids

Overview

Abdominal pain is a common presenting symptom in pediatrics primary care. Most of times it's due to benign causes without risk for complications, but severe abdominal pain maybe an alarming sign for abdominal pathology that requires surgical intervention.[1]

Historical Perspective

  • [Disease name] was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
  • In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
  • In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].

Classification

  • Abdominal pain in children may be classified according to age into two groups:[2]
    • Abdominal pain in children below five years old.
    • Abdominal pain in children above five years old.
  • Other method for classification of abdominal pain can be according to the duration of the pain[3]:
    • Acute Abdominal pain(less than 1 week).
    • Chronic Abdominal pain(more than 1 week).

Pathophysiology

  • The pathogenesis of [disease name] is characterized by [feature1], [feature2], and [feature3].
  • The [gene name] gene/Mutation in [gene name] has been associated with the development of [disease name], involving the [molecular pathway] pathway.
  • On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
  • On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Causes

There is a wide range of causes for pediatric abdominal pain which maybe due to a disease in variety of systems. In general, differentiating between acute and chronic pain in children is not easy, Despite it's being benign conditions in most children presenting with abdominal pain but some serious conditions may be the cause of the abdominal pain. On the table below there's some systems and related diseases that can cause abdominal pain in children:[4]

Causes of Abdominal pain In Children
System Disesease
Gastrointestinal Appendicitis[5], Gastrointestinal reflux disease[6], constipation [6],irritable bowel syndrome[7], celiac disease [8],Meckel's divreticulum[9], Intussusception[10], Volvulus[11].
Genitourinary Nephrolithiasis[12] , urinary tract infection[13]
Infections viral (mesenteric adenitis)[14]>, gastroenteritits[15]
Gynecologic Dysmenorrhea.[16]
Psychology Anxiety [17]

Differentiating [disease name] from other Diseases

For further information about the differential diagnosis, click here.

Epidemiology and Demographics

  • The pooled prevalence of abdominal pain in children is approximately 13.5% per 196,472 individuals worldwide.[18]
  • In 2001,the incidence of nonspecific abdominal pain was estimated to be 25% cases per 1,000 individuals in Netherland.[19]

Age

  • Patients of all age groups may develop [disease name].
  • [Disease name] is more commonly observed among patients aged [age range] years old.
  • [Disease name] is more commonly observed among [elderly patients/young patients/children].

Gender

  • Females are more commonly affected with abdominal pain than males.[20]

Race

  • There is no racial predilection for [disease name].
  • [Disease name] usually affects individuals of the [race 1] race.
  • [Race 2] individuals are less likely to develop [disease name].

Risk Factors

  • Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

Natural History, Complications and Prognosis

  • The majority of patients with [disease name] remain asymptomatic for [duration/years].
  • Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
  • If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
  • Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
  • Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with [disease name] is approximately [#%].

Diagnosis

Diagnostic Criteria

  • The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
  • [criterion 1]
  • [criterion 2]
  • [criterion 3]
  • [criterion 4]

Symptoms

  • [Disease name] is usually asymptomatic.
  • Symptoms of [disease name] may include the following:
  • [symptom 1]
  • [symptom 2]
  • [symptom 3]
  • [symptom 4]
  • [symptom 5]
  • [symptom 6]

Physical Examination

  • Patients with [disease name] usually appear [general appearance].
  • Physical examination may be remarkable for:
  • [finding 1]
  • [finding 2]
  • [finding 3]
  • [finding 4]
  • [finding 5]
  • [finding 6]

Laboratory Findings

  • There are no specific laboratory findings associated with [disease name].
  • A [positive/negative] [test name] is diagnostic of [disease name].
  • An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
  • Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Electrocardiogram

There are no ECG findings associated with [disease name].

OR

An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

X-ray

There are no x-ray findings associated with [disease name].

OR

An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with [disease name].

OR

Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

CT scan

There are no CT scan findings associated with [disease name].

OR

[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

MRI

There are no MRI findings associated with [disease name].

OR

[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Other Imaging Findings

There are no other imaging findings associated with [disease name].

OR

[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

  • [Disease name] may also be diagnosed using [diagnostic study name].
  • Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

  • There is no treatment for [disease name]; the mainstay of therapy is supportive care.
  • The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
  • [Medical therapy 1] acts by [mechanism of action 1].
  • Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery

  • Surgery is the mainstay of therapy for [disease name].
  • [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
  • [Surgical procedure] can only be performed for patients with [disease stage] [disease name].

Prevention

  • There are no primary preventive measures available for [disease name].
  • Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
  • Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].

References

  1. ↑ Kamgaing E, Kuissi; Rogombe S, Minto o; P, Mowangue; M, Njiomo; J, Koko; S, Ategbo (2017). "Epidemiological Aspects of Abdominal Pain in Children at the El Rapha Polyclinic in Libreville - Gabon". Clinical Pediatrics: Open Access. 02 (04). doi:10.4172/2572-0775.1000126. ISSN 2572-0775.
  2. ↑ Short AR (1935). "ABDOMINAL PAIN IN CHILDREN". Br Med J. 1 (3883): 1157–9. doi:10.1136/bmj.1.3883.1157. PMC 2460552. PMID 20779127.
  3. ↑ Eizenga W, Gieteling MJ, Berger M, Geijer RM (2013). "[Summary of the NHG guideline 'Abdominal pain in children', the 100th NHG guideline]". Ned Tijdschr Geneeskd. 157 (15): A6191. PMID 23575296.
  4. ↑ "Evaluation of abdominal pain in children - Etiology | BMJ Best Practice US".
  5. ↑ Marzuillo P, Germani C, Krauss BS, Barbi E (May 2015). "Appendicitis in children less than five years old: A challenge for the general practitioner". World J Clin Pediatr. 4 (2): 19–24. doi:10.5409/wjcp.v4.i2.19. PMC 4438437. PMID 26015876.
  6. ↑ 6.0 6.1 Moir CR (October 1996). "Abdominal pain in infants and children". Mayo Clin Proc. 71 (10): 984–9, quiz 989. doi:10.1016/S0025-6196(11)63773-7. PMID 8820774.
  7. ↑ Devanarayana NM, Rajindrajith S (June 2018). "Irritable bowel syndrome in children: Current knowledge, challenges and opportunities". World J Gastroenterol. 24 (21): 2211–2235. doi:10.3748/wjg.v24.i21.2211. PMC 5989237. PMID 29881232.
  8. ↑ Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean L, Mirzaa G, Amemiya A, Taylor AK, Lebwohl B, Snyder CL, Green P. PMID 20301720. Vancouver style error: initials (help); Missing or empty |title= (help)
  9. ↑ Keese D, Rolle U, Gfroerer S, Fiegel H (2019). "Symptomatic Meckel's Diverticulum in Pediatric Patients-Case Reports and Systematic Review of the Literature". Front Pediatr. 7: 267. doi:10.3389/fped.2019.00267. PMC 6606722 Check |pmc= value (help). PMID 31294008.
  10. ↑ Simon NM, Joseph J, Philip RR, Sukumaran TU, Philip R (January 2019). "Intussusception: Single Center Experience of 10 Years". Indian Pediatr. 56 (1): 29–32. PMID 30806357.
  11. ↑ Le CK, Nahirniak P, Anand S, Cooper W. PMID 28722866. Missing or empty |title= (help)
  12. ↑ "Nephrolithiasis - PubMed".
  13. ↑ Simões E Silva AC, Oliveira EA, Mak RH (2020). "Urinary tract infection in pediatrics: an overview". J Pediatr (Rio J). 96 Suppl 1: 65–79. doi:10.1016/j.jped.2019.10.006. PMID 31783012. Vancouver style error: missing comma (help)
  14. ↑ "Non-specific abdominal pain during school term may be due to viral infections then - PubMed".
  15. ↑ "Correction". Am Fam Physician. 99 (12): 732. June 2019. PMID 31194486.
  16. ↑ Gieteling MJ, Lisman-van Leeuwen Y, van der Wouden JC, Schellevis FG, Berger MY (2011). "Childhood nonspecific abdominal pain in family practice: incidence, associated factors, and management". Ann Fam Med. 9 (4): 337–43. doi:10.1370/afm.1268. PMC 3133581. PMID 21747105.
  17. ↑ Ramchandani PG, Hotopf M, Sandhu B, Stein A (July 2005). "The epidemiology of recurrent abdominal pain from 2 to 6 years of age: results of a large, population-based study". Pediatrics. 116 (1): 46–50. doi:10.1542/peds.2004-1854. PMID 15995029.
  18. ↑ "Epidemiology of Pediatric Functional Abdominal Pain Disorders: A Meta-Analysis".
  19. ↑ "Childhood Nonspecific Abdominal Pain in Family Practice: Incidence, Associated Factors, and Management | Annals of Family Medicine".
  20. ↑ BEACH Program, AIHW General Practice Statistics and Classification Unit (2004). "Presentations of abdominal pain in Australian general practice". Aust Fam Physician. 33 (12): 968–9. PMID 15630915.
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