DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20214082

Etiologies of abdominal pain emergencies in pediatrics

Hala Atta Youssef, Aishah Mohammad Alkhaldi, Manar Mohammed Alshahrani, Abdullah Tariq Almalki, Amjad Ali Alahmari, Nermeen Nasser Alrajhi, Layla Yasin Alsomali, Turki Sanat Alharbi, Mohammad Khaled Alkhater, Sawsan Saeed Bu Sarair, Ghadeer Ali Alghanem, Almoutazbillah Abdulrhman Khedrawi

Abstract


Reports showed that children usually complained of acute abdominal pain, which indicated the presence of severe underlying conditions and can have significant clinical importance. Serious challenges have been reported in healthcare settings where an urgent evaluation of the cases was necessary to adequately manage the patient before developing serious complications that might even end up with death. Some of these conditions included intussusception, appendicitis, volvulus and adhesions. Although estimates indicated that only around 1% of pediatric patients with acute abdominal pain usually required surgical intervention, concerns regarding the overlooking and misdiagnosis of significant conditions that might have severe prognostic outcomes were aroused among the different emergency departments. This study reviewed the common causes of acute abdominal pain among children admitted to the emergency department. Our results indicated that various etiologies can develop acute abdominal pain and therefore, establishing an adequate diagnosis by differentiating between the different etiologies should be done by the attending physicians to enhance the outcomes and adequately manage the admitted patients. Gastrointestinal causes of acute abdominal pain were the commonest to cause admissions to the emergency department. However, care should also be provided to the less common conditions, which might include genitourinary and pulmonary disorders and therefore, a thorough examination of children should be provided not to conduct a misdiagnosis of the underlying condition.


Keywords


Acute abdominal pain, Emergency, Pediatrics, Management, Diagnosis

Full Text:

PDF

References


D'Agostino J. Common abdominal emergencies in children. Emerg Med Clin North Am. 2002;20(1):139-53.

Grant HW, Parker MC, Wilson MS, Menzies D, Sunderland G, Thompson JN, et al. Adhesions after abdominal surgery in children. J Pediatr Surg. 2008;43(1):152-6.

Scholer SJ, Pituch K, Orr DP, Dittus RS. Clinical outcomes of children with acute abdominal pain. Pediatrics. 1996;98:680-5.

Kim JS. Acute abdominal pain in children. Pediatr Gastroenterol Hepatol Nutr. 2013;16(4):219-24.

Omling E, Salö M, Saluja S, Bergbrant S, Olsson L, Persson A, et al. Nationwide study of appendicitis in children. British J Surg. 2019;106(12):1623-31.

Papandria D, Goldstein SD, Rhee D, Salazar JH, Arlikar J, Gorgy A, et al. Risk of perforation increases with delay in recognition and surgery for acute appendicitis. J Surg Res. 2013;184(2):723-9.

Howell EC, Dubina ED, Lee SL. Perforation risk in pediatric appendicitis: assessment and management. Pediatric Health Med Ther. 2018;9:135-45.

Karabulut R, Sonmez K, Turkyilmaz Z, Demirogullari B, Ozen IO, Demirtola A, et al. Negative appendectomy experience in children. Ir J Med Sci. 2011;180(1):55-8.

Gross I, Siedner-Weintraub Y, Stibbe S, Rekhtman D, Weiss D, Simanovsky N, et al. Characteristics of mesenteric lymphadenitis in comparison with those of acute appendicitis in children. Eur J Pediatr. 2017;176(2):199-205.

Jiang J, Jiang B, Parashar U, Nguyen T, Bines J, Patel MM. Childhood intussusception: a literature review. PloS One. 2013;8(7):68482.

Hansen CC, Søreide K. Systematic review of epidemiology, presentation, and management of Meckel's diverticulum in the 21st century. Medicine. 2018;97(35):12154.

Elsayes KM, Menias CO, Harvin HJ, Francis IR. Imaging manifestations of Meckel's diverticulum. AJR Am J Roentgenol. 2007;189(1):81-8.

Lin XK, Huang XZ, Bao XZ, Zheng N, Xia QZ, Chen CD. Clinical characteristics of Meckel diverticulum in children: A retrospective review of a 15-year single-center experience. Medicine. 2017;96(32):7760.

Smith DA, Kashyap S, Nehring SM. Bowel Obstruction. Treasure Island (FL): StatPearls Publishing; 2021.

Reddy SR, Cappell MS. A systematic review of the clinical presentation, diagnosis, and treatment of small bowel obstruction. Curr Gastroenterol Rep. 2017;19(6):28.

Cappell MS, Batke M. Mechanical obstruction of the small bowel and colon. Med Clinic North Am. 2008;92(3):575-97.

Waldman AR. Bowel obstruction. Clinic J Oncol Nurs. 2001;5(6):281-2.

Baron TH. Acute colonic obstruction. Gastrointest Endosc Clin North Am. 2007;17(2):323-39.

Canon CL, Baron TH, Morgan DE, Dean PA, Koehler RE. Treatment of colonic obstruction with expandable metal stents: radiologic features. AJR Am J Roentgenol. 1997;168(1):199-205.

Barth X. Intestinal obstruction of the colon: physiopathology, etiology, diagnosis, treatment. La Revue Praticien. 2001;51(7):783-7.

Casa C, Arnaud JP. Intestinal obstruction of the colon. Physiopathology, etiology, diagnosis, treatment. La Revue praticien. 1997;47(16):1833-6.

Shalaby MS, Kuti K, Walker G. Intestinal malrotation and volvulus in infants and children. BMJ. 2013;347:6949.

Neu J, Walker WA. Necrotizing enterocolitis. New England J Med. 2011;364(3):255-64.

Sullivan PB. Peptic ulcer disease in children. Paediatr Child Health. 2010;20(10):462-4.

Singh P, Arora A, Strand TA, Leffler DA, Catassi C, Green PH, et al. Global Prevalence of celiac disease: systematic review and meta-analysis. Clinic Gastroenterol Hepatol. 2018;16(6):823-36.

Suzuki M, Sai JK, Shimizu T. Acute pancreatitis in children and adolescents. World J Gastrointest Pathophysiol. 2014;5(4):416-26.

Bradshaw CJ, Bandi AS, Muktar Z, Hasan MA, Chowdhury TK, Banu T, et al. International study of the epidemiology of paediatric trauma: PAPSA Research Study. World J Surg. 2018;42(6):1885-94.

Ladomenou F, Bitsori M, Galanakis E. Incidence and morbidity of urinary tract infection in a prospective COHORT of children. Acta Paediatrica. 2015;104(7):324-9.

DeSanctis V, Soliman A, Bernasconi S, Bianchin L, Bona G, Bozzola M, et al. Primary dysmenorrhea in adolescents: prevalence, impact and recent knowledge. Pediatr Endocrinol Rev. 2015;13(2):512-20.

Lavallee ME, Cash J. Testicular torsion: evaluation and management. Curr Sport Med Rep. 2005;4(2):102-4.

Boyle KJ, Torrealday S. Benign gynecologic conditions. Surg Clin North Am. 2008;88(2):245-64.

Kelleher CM, Goldstein AM. Adnexal masses in children and adolescents. Clinic Obstetr Gynecol. 2015;58(1):76-92.

Emeksiz HC, Derinöz O, Akkoyun EB, Güçlü Pınarlı F, Bideci A. Age-specific frequencies and characteristics of ovarian cysts in children and adolescents. J Clinic Res Pediatr Endocrinol. 2017;9(1):58-62.

Das BB, Ronda J, Trent M. Pelvic inflammatory disease: improving awareness, prevention, and treatment. Infect Drug Resist. 2016;9:191-7.

Bouyer J, Coste J, Fernandez H, Pouly JL, Job-Spira N. Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Human Reproduct. 2002;17(12):3224-30.

Gaskins AJ, Missmer SA, Rich-Edwards JW, Williams PL, Souter I, Chavarro JE. Demographic, lifestyle, and reproductive risk factors for ectopic pregnancy. Fertil Steril. 2018;110(7):1328-37.

Rasquin A, DiLorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterol. 2006;130(5):1527-37.

Boronat AC, Ferreira-Maia AP, Matijasevich A, Wang YP. Epidemiology of functional gastrointestinal disorders in children and adolescents: a systematic review. World J Gastroenterol. 2017;23(21):3915-27.