Acute Abdomen in Children - Investigation,Management,Treatment,Diagnosis

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Gastrointestinal Disorders in Children

Acute Abdomen

Gastrointestinal Disorders in Children

Zinc and ORS

Acute Diarrhea in Children

Inflammatory Bowel Disease/IBD

Acute Childhood Diarrhea: Review of Recent Advances in Standard Management

Zinc For The Prevention Of Diarrhea

Oral Rehydration Therapy

Approach To Acute Abdominal Pain In Children

Trachea oesophageal fistula

Vomiting and Diarrhea in Children

Upper Gastrointestinal bleed

ORS - Which one to use?

Acute Abdomen

Malabsorption syndromes

Prevention of Diarrhea

Lactose Intolerance in Infants, Children, and Adolescents

Biliary Atresia and Kasai's Surgery - When is it too Late

Clinical Tools

Clinical Vignettes

Diseases & Conditions

Drugs Interaction Calculator

Podcasts

Patient Management Online

Diagnostic Dilemma

Question of the Day

Diagnostic Aid

VACCINE REMINDER

"Get the Vaccine Schedule for your child."

Ask Queries

SPECIALIST ANSWERS

Today's Poll

Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

Vote

Results

ACUTE ABDOMEN

Related topics

Abdominal Pain and Causes of Acute Abdomen

Dr Ira Shah
M.D, DCH(Gold Medalist), FCPS, DNB

Investigations in a child with acute abdomen:

Abdominal X-Ray/Chest X-Ray erect - Look for bowel obstruction calcification, free air and lower lobe pneumonia. Also soft tissue mass may be seen

Ultrasound of both pelvis and upper abdomen - For hepatobiliary, renal and gynaecological pathology.

Complete blood count Increased in case of necrosis, bacterial infection, abscess.

Peripheral smear for HUS, Sickle cell.

Urine examination for UTI, porphyria

Additional investigations

Serum Amylase/lipase - for pancreatitis

Blood cultures

Beta HCG

CT scan for abdomen

Stool examination for worm infestation

Typical presenting clinical characteristics of common abdominal disorders in infants and children

Dia gnosis	Age/ Sex	History	Physi cal Exami nation	Lab Ana- lysis	Radio logy (Abdo men)	Treat- ment
Appen dicitis	Peak: 10-12 years M:F=3:2	Perium bilical pain (early) followed by vomiting and localized right lower quadrant pain.	Fever > 100.5 degree F. Localized right lower quadrant peritonitis	Increased WBC(> 10000/ cu mm)	X-Ray Concave curvature of spine to the right. Presence of faecolith in 5- 10% USG Pericolic / appen- dicea fluid and/or edema.	- IV Fluids, Antibio tics, Antispas modics Appen dec- tomy
Intussu ception	5-9 months M:F= 3:2	Paroxysmal crampy abdominal pain followed by periods of calm Nonbilious vomiting (early), later bilious vomiting Currant jelly stools.	Fever Disten sion (late sign) Right Sided mass (85%)	Dehy dration Pallor Later increased WBC.	X-Ray - Obstructive pattern USG - "Pseudo kidney" and "target" sign Contrast enema - Intussu ception and failure of gas/ contrast to reflux in the small bowel	Ba enema/ Gastro graffin enema, In severe cases: Opera tive reduc- tion, Resec tion and end-to -end anasto mosis.
Malrota tion / midgut volvulus	< 1 month M:F=3:2	Unexpected bilious vomiting in an otherwise healthy infant	Is normal inearly stages There may be tender ness. Disten sion and peritonitis maybe late features	Dehy dration Anemia Increased WBC (late sign).	X-Ray - Distended stomach, gasless abdomen (high obstruc- tion) Upper GL contrast Study - Abnormal duodenal sweep Lower GI contrast study - Caecum in the left abdomen or RUQ	Surgi cal reduc- tion, Adhesio nolysis.
Incar cerated inguinal hernia	<1 year F>M	Irritability, Crampy, abdominal pain. Early - nonbilious vomiting, later bilious vomiting. Previously noted groin mass.	Firm, tender groin or scrotal mass. Abdo minal disten sion is seen in late stages	Dehy dration - Later- Increased WBC	X-Ray - Obstructive pattern	Surgery and hernio- tomy.
Choleli thiasis	All	Associated illness Hemolytic anemia Nausea, vomiting, Vague right upper quadrant pain	Minimal physical findings	Normal	USG - Gall bladder stones/ sludge	Cholecy stec- tomy
Chole cystitis	All	Fever Right upper quadrant pain Nausea, vomiting	Fever, Right upper quadrant tenderness Mass	Increased LFT, Increased WBC	USG - Gall bladder distension, thickening, stones/ sludge Pericho lecystic fluid HIDA scan- Non functioning gall bladder	IV Fluids, IV antibio tics, Antispa smodics, Cholecy stec- tomy

Management of acute abdomen

Along with treatment of the specific conditions, patients may require intravenous fluids, antibiotics and antispasmodics. The commonly used antibiotics are ampicillin (100 mg/kg/d), gentamicin (5 mg/kg/d), clindamycin (40 mg/kg/d) or metronidazole (30 mg/kg/d). Other antibiotics such as third generation cephalosporins are also useful. Surgical treatment would depend on the presenting cause.

See Expertise Views On "Abdominal Pain" Questions

Last created on 23-02-2001
Last updated on 01-07-2006

Mail To Your Friend

Print This Article

Diseases & Conditions

Pediatric Oncall Journal

Pediatric Conferences

Ped Tools

Adverse Drug Reactions

Pediatric oncall book store

Partner Sites

Infection in Children

Pedcall

Medical ADRIS

Vaccine Reminder

Pediatric Oncall Journal

Educational Section

Disclaimer:

The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.

Sitemap For Doctor

Sitemap For Parent

Sitemap For Kids