This article intends to help the physician make that decision based on age of the patient, localization, associated symptoms and insight into some disorders. Table-1 enumerates the common causes of acute abdominal pain at different age groups. Table -2 lists the red flag signs elaborated in the text. The flow charts (Figure -1) are designed to help distinguish between common problems based on localization and symptoms associated with abdominal pain. These have been cross-referenced with signs and symptoms of that particular disorder. The text provides insight into and fallacies of diagnosis of common causes of abdominal pain. It is assumed that the pediatrician has access to basic investigations such as X-ray, ultrasound, blood chemistry and hemogram.

NEWBORN

Abdominal pain in newborns manifests as incessant crying, drawing up of the legs, irritability along with non-specific signs such as poor feeding. Almost every baby has a number of self-limiting episodes of crying supposedly due to abdominal pain. These are to be differentiated from persistent episodes causes by serious conditions (Table -1). Neonatal infection and other non-GI causes can mimic clinical signs of abdominal pain. (See 'Non GI causes of pain in children < 2 years' below).

Rule

The baby is assumed to be having a serious or surgical cause till proven otherwise by examination, investigations and/or observation over time.
Clinical pointers towards possible serious or surgical condition