Abdominal pain (peds): Difference between revisions
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{{PediatricPage|abdominal pain| abdominal pain in pregnancy|abdominal pain (geriatrics)}} | {{PediatricPage|abdominal pain| abdominal pain in pregnancy|abdominal pain (geriatrics)}} | ||
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*Bilious emesis is a surgical emergency until proven otherwise | *Bilious emesis is a surgical emergency until proven otherwise | ||
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*May be associated with [[Special:MyLanguage/nausea|nausea]], [[Special:MyLanguage/vomiting|vomiting]], or [[Special:MyLanguage/diarrhea|diarrhea]] | *May be associated with [[Special:MyLanguage/nausea|nausea]], [[Special:MyLanguage/vomiting|vomiting]], or [[Special:MyLanguage/diarrhea|diarrhea]] | ||
*[[Special:MyLanguage/Fever|Fever]] may be present in pain from infectious etiology | *[[Special:MyLanguage/Fever|Fever]] may be present in pain from infectious etiology | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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{{Pediatric abdominal pain DDX}} | {{Pediatric abdominal pain DDX}} | ||
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**[[Special:MyLanguage/Abdominal radiography|Abdominal radiography]] | **[[Special:MyLanguage/Abdominal radiography|Abdominal radiography]] | ||
***[[Special:MyLanguage/acute abdominal series|Abdominal plain xray]] films are specific, but not sensitive. As such, they have very little utility in the workup of pediatric abdominal pain, unless concerned for a [[Special:MyLanguage/Esophageal foreign body|foreign body]]. Do NOT use films to "confirm" a diagnosis of "constipation," as this is not specific and may also be found during surgical emergencies (e.g. [[Special:MyLanguage/appendicitis|appendicitis]]). | ***[[Special:MyLanguage/acute abdominal series|Abdominal plain xray]] films are specific, but not sensitive. As such, they have very little utility in the workup of pediatric abdominal pain, unless concerned for a [[Special:MyLanguage/Esophageal foreign body|foreign body]]. Do NOT use films to "confirm" a diagnosis of "constipation," as this is not specific and may also be found during surgical emergencies (e.g. [[Special:MyLanguage/appendicitis|appendicitis]]). | ||
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*Based on diagnosis | *Based on diagnosis | ||
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**If symptoms are fully resolved and the patient has a benign abdominal exam, most patients go home with return precautions | **If symptoms are fully resolved and the patient has a benign abdominal exam, most patients go home with return precautions | ||
**In general, unclear cases with continued pain should NOT be discharged home | **In general, unclear cases with continued pain should NOT be discharged home | ||
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*[[Special:MyLanguage/Meckel's Diverticulum|Meckel's Diverticulum]] | *[[Special:MyLanguage/Meckel's Diverticulum|Meckel's Diverticulum]] | ||
*[[Special:MyLanguage/Inguinal Hernia (Peds)|Inguinal Hernia (Peds)]] | *[[Special:MyLanguage/Inguinal Hernia (Peds)|Inguinal Hernia (Peds)]] | ||
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[[Category:GI]] | [[Category:GI]] | ||
[[Category:Symptoms]] | [[Category:Symptoms]] | ||
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Latest revision as of 21:29, 17 January 2026
This page is for pediatric patients. For adult patients, see: abdominal pain,abdominal pain in pregnancy, and abdominal pain (geriatrics)
Background
- Bilious emesis is a surgical emergency until proven otherwise
Clinical Features
- Abdominal pain
- May be associated with nausea, vomiting, or diarrhea
- Fever may be present in pain from infectious etiology
Differential Diagnosis
Pediatric Abdominal Pain
0–3 Months Old
- Emergent
- Nonemergent
3 mo–3 y old
- Emergent
- Nonemergent
3 y old–adolescence
- Emergent
- Nonemergent
Evaluation
Depends on location and history
- Consider:
- hCG
- Consider ectopic pregnancy in any female of reproductive age
- Urinalysis
- CBC
- Chemistry
- hCG
- Possible imaging:
- Ultrasound
- Appropriate for intussusception, ovarian/testicular torsion, gallbladder, pregnancy, appendicitis
- CT
- May be associated with 1/1,000 lifetime risk of malignancy
- Abdominal radiography
- Abdominal plain xray films are specific, but not sensitive. As such, they have very little utility in the workup of pediatric abdominal pain, unless concerned for a foreign body. Do NOT use films to "confirm" a diagnosis of "constipation," as this is not specific and may also be found during surgical emergencies (e.g. appendicitis).
- Ultrasound
Management
- Based on diagnosis
Disposition
- Depends on underlying etiology
- If symptoms are fully resolved and the patient has a benign abdominal exam, most patients go home with return precautions
- In general, unclear cases with continued pain should NOT be discharged home
See Also