Acute abdominal pain


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This presentation is made by Dr Ashok Jaisingani for study purpose if any one like this than please give comments.

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Acute abdominal pain

  1. 1. Acute Abdominal Pain Dr. Ashok Jaisingani
  2. 2. Introduction► Between one-third to one-half of the child admitted hospital for acute abdominal pain have non-specific abdominal pain.► Another one-third have acute appendicitis.► Other relatively benign condition also cause abdominal pain such as constipation, urinary tract infection account for most of remain.
  3. 3. Work-up Of child with Acute Abdominal Pain► A careful history and examination and active observation are paramount.► Routine test include urine analysis, microscopy and culture.► Frequently helpful tests such as abdominal ultrasound scan can diagnose pelvic, UTI and GIT pathology.► Occasionally helpful a plain supine radiograph particularly in preschool child with pain and vomiting, urea and electrolytes and CBC.► Selective specific investigation are blood culture, stool culture, plasma amylase and diagnostic laparoscopy.
  4. 4. Acute Non – Specific Abdominal Pain► Pain is poorly localized, not aggravated by movement and rarely accompanied by guarding.► Site and severity of maximum tenderness often vary during the course of repeated examination.► Symptoms are usually self limiting within 24h.► The etiology of non-specific pain in children is obscure but viral infection and transitient intussusception are account for some cases.► Mesenteric adenitis a viral infection causing widespread 1- Reactive lymphadenopathy 2- Fever 3- Diffuse Abdominal Pain.
  5. 5. Other Causes Of Acute Abdominal Pain► Intestinal Obstruction► Constipation► Urinary Tract Infection► Gastroenteritis► Tropical Disease► There are numerous rare cause of abdominal pain in children are 1- Henoch-schonlen purpura 2- Sickle Cell Disease 3- Primary peritonitis, acute pancreatitis and biliary colic 4- Testicular torsion and gynecological pathology 5- Urinary stone disease.
  6. 6. Intestinal Obstruction► Intestinalobstruction in children caused by► Intussusception► Inguinal Hernia► Adhesion► Meckel’s diverticulum
  7. 7. Constipation► The passage of hard or infrequent stool.► Constipation is more often cause acute abdominal pain when it is secondary to 1- Anal Fissure 2- Hirschsprung’s Disease 3- Anorectal malformation 4- Neuropathic bowl.► Rectal examination and plain abdominal radiography may helpful in severe cases.
  8. 8. Urinary Tract Infection► UTI is an uncommon cause of abdominal pain.► Urinary symptoms vomiting and fever tend to be predominant.► Definitive infection can be confirmed by urinalysis, microscopy and culture.► Sterile pyuria may accompany acute appendicitis► Child with pelviuretic junction obstruction present with acute or recurrent abdominal pain with no urinary symptoms.
  9. 9. Gastroenteritis► Itmay cause colicky abdominal pain.► Onset of pain before the diarrhea and presence of lower abdominal tenderness should raise suspicion of appendicitis.► Pelvic tenderness on rectal examination may be useful pointer to appendicitis.
  10. 10. Tropical Diseases► Tropical Diseases causing acute abdominal pain are 1- Ascariasis 2- Typhoid 3- Amoebiasis