Abdominal pain in children SGD Dr Saffiullah AP Paeds

Learning outcomes At the end of this discussion you should be able to 1.Know different techniques in examining abdomen in children presenting with this symptom 2.Know the important differential diagnosis in children with abdominal pain 3.Plan appropriate investigations and management

Examination General appearance Abdominal examination Cough/jump/blow abdomen/gait Systemic examination

Techniques Inspection Observations Distraction Play Parent’ help

Causes of Abdominal pain Medical causes Surgical causes GI causes Hepatobiliary causes Systemic causes Genitourinary causes Referred pain Drugs

Case 1 6 years old girl with 2 days history of crampy abdominal pain. It is associated with vomiting with the last vomitus been reported as green. She has past history of appendisectomy 12 months back.

Case 2 A 10 months old girl was seen with history of abdominal pain and failure to thrive for the last 4 months. She also has symptoms of loose stool and abdominal distension. On examination she was alert but miserable and pale.

Case 3 A previously healthy 8-years old was seen in the casualty with complaints of episodic abdominal pain for the last several months. The pain was periumbilical and sharp but does not wake her up from sleep or interfere with play. Her systemic examination was unremarkable.

Case 4 A12 years old girl presented to emergency department with history of being unwell. She had abdominal pain and vomiting for the last 1 day.Her mother reports weight loss and has recently stared bed wetting after been dry for many years.

Case 5 A 9 years old girl was brought by her parents to OPD with history of abdominal pain for the last 6 months. They also reported bloody diarrhoea, loss of appetite and weight loss. On examination she was pale, afebrile and looked thin. She had many oral ulcers.

Case 6 A 6 years old boy presented with abdominal pain for the last 1 day.He also has fever, cough and is breathless.

Thank you