Clinical Characteristics and Diagnostic Approaches in Children with Acute Abdominal Pain: A Tertiary Pediatric Center Experience

Abstract

Objective: Our aim in this study is to evaluate the clinical characteristics, physical examination findings, laboratory tests, and treatment approach of pediatric acute abdominal pain. Materials and Methods: Between January 2016 and January 2021, medical records of patients aged 2–18 years presenting to the pediatric emergency department with acute abdominal pain were retrospectively reviewed and classified into medical or surgical diagnosis groups based on final diagnoses. Results: The study was conducted with 1980 cases, 54.3% (n=1076) of the cases were girls, and the average age was 8±3.8 years. Apart from the complaint of acute abdominal pain, 69% (n=1366) of the cases had additional complaints. Symptoms accompanying acute abdominal pain were vomiting (28.1%), fever (17.3%), nausea (14.7%), and diarrhea (14%). Vomiting was more common in the surgical group (p<0.001), whereas fever predominated in the medical group (p=0.021). The most common cause in children presenting with acute abdominal pain was medical diseases, these medical causes are acute gastroenteritis (24.9%, n=493), constipation (19.1%, n=378), upper respiratory tract infection (17.8%, n=353), urinary tract infection (13.2%, n=262), functional abdominal pain (12.2%, n=241), mesenteric lymphadenitis (3.8%, n=75), lower respiratory tract infection (2.8%, n=55), and hypercalciuria (2.5%, n=49). Causes of acute abdominal pain requiring urgent surgical treatment were found in 5.3% (n=104). The detection of features in the physical examination of the cases was 39.4%, and laboratory examination was 78.5%, any imaging was 70.6%, and the hospitalization rate was 5.8%. The rate of observation and hospitalization was statistically higher in the surgical diagnosis group compared to the medical diagnosis group (p<0.001). Conclusion: Vomiting was more common in the surgical group, whereas fever was less common. Urgent surgical treatment rates were low. Vomiting, fever, nausea, and diarrhea accompanied acute abdominal pain, mostly, and the most common medical causes were gastroenteritis, constipation, and upper respiratory tract infection.

Keywords

• Acute abdominal pain
• appendicitis
• child
• gastroenteritis

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