Aims and objectives
Referred abdominal pain is a known symptom in pneumonia.
The usual situation involves a basilar pneumonia.
When the pain occurs,
it becomes important,
because it focuses attention to the digestive tract,
tending to cause errors and delay of the diagnosis.
Our purpose was to evaluate the imaging and the associated clinical signs of children arriving to the Emergency Room with pneumonia and abdominal pains.
Methods and materials
A 5 year retrospective study was conducted.
Chest and abdominal x-rays,
CT scans together with the associated clinical signs were analysed.
Localisation and patterns of the pneumonic infiltrate were described.
LEFT LOWER LOBE
48 males and 30 females between 2 and 17 years were identified.
The most frequent complaints were fever and cough.
Chest pain was surprisingly rare,
Other symptoms associated to the digestive tract included nausea,
gastroenteritis and flank pain.
Acute abdomen mimicking acute appendicitis resulted in 6 CT scans revealing a normal appendix and pneumonia of the lower lobes.
Pleural effusion was drained in the US unit in 7 patients.
Mesenteric lymphadenitis was described in US or CTperformed in...
Around 2-5% of children with pneumonia have associated abdominal pains,
far more diffuse,
However occasionally it may be so violent and especially when associated with paralytic ileus,
vomiting and diarrhea,
as to overshadow the thoracic symptoms.
leading to superfluous US and CT examinations.
The presumed first reported etiology was referred pain from intercostals and diaphragmatic nerves irradiating from the pleura to the abdomen,
obviously caused by basilar infiltrates only.
A functional dyspepsia resulting from the general toxemia was also reported.
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