Type:
Educational Exhibit
Keywords:
Acute, Diagnostic procedure, Decision analysis, Ultrasound-Power Doppler, Ultrasound-Colour Doppler, Ultrasound, Paediatric, Emergency, Abdomen
Authors:
V. Miele1, G. L. Buquicchio2, V. Di Giacomo2, I. Di Giampietro2, S. Ianniello2, G. Menichini1, B. sessa1, M. Trinci3; 1Roma/IT, 2Rome/IT, 3Roma, ITALY/IT
DOI:
10.1594/ecr2013/C-0870
Background
Abdominal pain is a common cause of presentation in the Pediatric Emergency Department.
Ultrasound is the first line imaging method to evaluate abdominal pain.
The most fraquent causes of presentation in Pediatric Emergency Department are listed below:
-
Cry
-
Vomiting
-
Intestinal occlusion,
sub-occlusion,
diarrhea
-
Abdominal pain,
pelvic pain
-
Fever
-
Palpable mass
-
Trauma
-
Foreign bodies or substances ingestion
-
Articular pain
The aetiology of acute abdomen in pediatric population depends on the age.
In newborns:
- acute gastroenteritis
- intestinal occlusion (es: congenital megacolon)
- intussusception
- incarcerated hinguinal hernia
- torsion of spermatic funicle
- acute appendicitis (rare)
2-6 years old children:
- acute gastroenteritis
- constipation
- urinary infections
- trauma
- acute appendicitis
- pneumonia
- mesenteric adenitis
>6 years-old:
- acute gastroenteritis
- constipation
- recurrent abdominal pain syndrome
- trauma
- acute appendicitis
- urinary infections
- mesenteric adenitis.
Less frequent causes of acute abdominal pain in children aged 2-6:
- Meckel's diverticulitis Fig. 2
- Schonlein Henoch purpura
- intestinal intussusception Fig. 3
- nephrolithiasis
- uremic hemolytic syndrome
- tumours (Wilm's tumour; neuroblastoma)
- hepatitis
- diabetic ketoacidosis
In children >6 years-old:
- pneumonia
- Chron's disease Fig. 4
- ulcerative colitis
- peptic ulcer
- cholecystitis
- pancreatic disorders
- diabetic ketoacidosis
- torsion of ovarian cysts
- pregnancy
In children the localization of abdominal pain is not indicative of a specific pathology as in the adults.
In fact,
young patients usually refer the pain in the center of the abdomen.
[1,2]