Emergent evaluation of the child with acute abdominal pain
- Mark I Neuman, MD, MPH
Mark I Neuman, MD, MPH
- Associate Professor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Richard M Ruddy, MD
Richard M Ruddy, MD
- Professor of Clinical Pediatrics
- University of Cincinnati College of Medicine
- Section Editors
- Gary R Fleisher, MD
Gary R Fleisher, MD
- Editor-in-Chief — Adult and Pediatric Emergency Medicine
- Section Editor — Pediatric Signs and Symptoms
- Egan Family Foundation Professor
- Harvard Medical School
- Jan E Drutz, MD
Jan E Drutz, MD
- Section Editor — General Pediatrics
- Professor of Pediatrics
- Baylor College of Medicine
- Melvin B Heyman, MD, MPH
Melvin B Heyman, MD, MPH
- Section Editor — Pediatric Gastroenterology
- Professor of Pediatrics
- University of California, San Francisco
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
The emergent evaluation of children with acute abdominal pain, including a brief description of life-threatening and common causes, will be discussed here.
The evaluation and management of children with chronic abdominal pain is reviewed separately. (See "Chronic abdominal pain in children and adolescents: Approach to the evaluation" and "Functional abdominal pain in children and adolescents: Management in primary care".)
Among children, abdominal pain is a frequent, nonspecific symptom that is typically associated with self-limited conditions such as gastroenteritis, constipation, and viral illnesses. The challenge for the clinician is to identify patients with abdominal pain who may have the following:
●Serious, potentially life-threatening conditions, such as an acute abdomen from appendicitis or bowel obstruction (as can occur from volvulus, intussusception, or adhesions); acute manifestations of inflammatory bowel disease, pancreatitis, hepatitis or intra-abdominal mass.
●Extra-abdominal infections that require specific treatment (such as streptococcal pharyngitis, urinary tract infection, or pneumonia)To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- - Trauma
- - Characteristics of abdominal pain
- - Associated symptoms
- - Past medical history
- Physical examination
- - Appearance
- - Vital signs
- - Abdominal examination
- - General examination
- Ancillary studies
- - Laboratory studies
- - Imaging
- ALGORITHMIC APPROACH
- Signs of obstruction or peritoneal irritation
- Focal physical findings
- - Extraabdominal
- - Mass
- - Focal tenderness
- Colicky pain
- Nonspecific symptoms
- Adolescent females
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS