Paediatric Acute Abdominal Pain
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Paediatric Acute Abdominal Pain

Paediatrics

Acute abdominal pain is a common symptom in paediatrics, referring to sudden discomfort or pain in the abdomen in children. This pain may appear rapidly and vary in intensity, ranging from mild discomfort to severe pain. Various reasons, including issues in the digestive system, urinary system, or other internal organs, can cause acute abdominal pain. Most cases of acute abdominal pain in children are due to constipation or gastroenteritis, which are mild and can be relieved with general supportive measures without the need for hospitalization. However, severe diarrhoea can lead to electrolyte imbalances, resulting in seizures, arrhythmias, severe dehydration, and organ failure, so parents must be vigilant and seek medical attention early. The causes of acute abdominal pain also include diseases requiring surgical treatment, such as appendicitis and intussusception; delaying treatment may pose a risk to life.

Symptoms

The symptoms of acute abdominal pain in children can vary, and depending on the underlying cause, the nature and severity of the symptoms may differ. Here are some common symptoms:

  • Abdominal pain: This is the primary symptom, and the pain may be localized to a specific area of the abdomen, such as the lower right side (possibly indicating appendicitis), or it may be distributed throughout the abdomen. The nature of the pain can be continuous, intermittent, dull, or sharp.
  • Vomiting: Many conditions that cause acute abdominal pain may be accompanied by vomiting, especially gastroenteritis or food poisoning, among others.
  • Diarrhoea: Infections like gastroenteritis can also lead to diarrhoea, which may result in dehydration, especially in infants and young children.
  • Fever: Fever may accompany conditions like gastroenteritis, appendicitis, and urinary tract infections, among others, which cause acute abdominal pain.
  • Loss of appetite: A child may not feel like eating due to abdominal pain or other related symptoms.
  • Fatigue or malaise: The child may appear more tired or less active than usual.
  • Changes in bowel habits, Such as constipation or painful bowel movements.
  • Abdominal bloating: It may manifest as abdominal bloating or the child complaining of feeling "gassy" in the abdomen.

Causes and Factors

The causes and risk factors of acute abdominal pain in children are pretty varied. Here are detailed introductions to several common reasons:

Constipation

Causes: Caused by infections with viruses, bacteria, or parasites.

Risk factors include poor hygiene practices, consuming undercooked food, and contact with infected individuals.

Gastroenteritis

Causes: Caused by infections with viruses, bacteria, or parasites.

Risk factors include poor hygiene practices, consuming undercooked food, and contact with infected individuals.

Food Sensitivity, Food Poisoning

Causes: Food sensitivity is caused by an allergic reaction to food components. Food poisoning is from consuming food contaminated with bacteria, viruses, or toxins.

Risk Factors: Eating foods containing allergens and consuming improperly processed or stored food.

Surgical Diseases
Appendicitis

Causes: Infection and inflammation can be triggered when the appendix becomes blocked.

Risk Factors: Typically occurs in children to teenagers.

Intussusception

Causes: Part of the intestine slides into an adjoining part of the intestine, causing a blockage.

Risk Factors: More common in infants and young children.

Middle Ear Infection

Causes: Infection inside the ear.

Risk Factors: Underdeveloped immune system, frequent colds, or upper respiratory infections.

Migraine

Causes: Changes in the blood vessels of the brain.

Risk Factors: Family history, stress, certain foods, or environmental factors.

Psychosomatic Issues

Causes: Stress, anxiety, or emotional issues can manifest as abdominal pain.

Risk Factors: Family issues, school pressure, or psychological trauma.

Understanding these causes and their risk factors can help prevent and promptly identify potential health problems in children. If a child experiences acute abdominal pain, especially if accompanied by other severe symptoms, medical help should be sought immediately.

Diagnosis and Treatments

Diagnosis

  • Clinical diagnosis: Doctors will inquire about medical history and perform a physical examination to diagnose the cause of abdominal pain and assess the severity of the condition.
  • Laboratory and imaging tests: Doctors will decide whether to arrange tests based on the situation, including stool analysis, blood tests, abdominal X-rays, ultrasound, etc.
     


Treatment

  • If constipation causes abdominal pain, the doctor may prescribe medication to help the child pass stool.
  • If diarrhoea is severe, the doctor may prescribe an oral rehydration solution to treat and prevent dehydration or electrolyte imbalance.
  • If appendicitis or intussusception is suspected, hospitalization may be required.
  • If the abdominal pain is not due to gastrointestinal issues, the doctor will recommend an appropriate treatment plan.

If any of the following conditions occur, the child should be taken to the emergency room as soon as possible: altered mental state/signs of dehydration, such as reduced urine output, irritability, lethargy, dry mucous membranes/difficulty eating / rectal bleeding / persistent vomiting, or vomiting with yellow-green bile, blood, or coffee-ground appearance / persistent or severe diarrhoea / severe abdominal pain, bloating / high fever, difficulty urinating, ear pain, etc.
If the condition is not severe, home care may be appropriate. Most cases of abdominal pain can be observed and treated at home. The diet should be light, with small, frequent meals. However, attention should be paid to changes in the condition, including vomiting, bowel movements, bloating, worsening abdominal pain, shifting pain location, proper disposal of vomit and manure, and monitoring of urine output to prevent dehydration.

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