Acute abdominal pain in children
Stuart J Fergusson and Alasdair H B Fyfe
As in adult surgery one of the most common acute presentations in paediatric surgery is abdominal pain. A thorough understanding of this topic is important not only for the paediatric surgeon but also for the general practitioner, the medical paediatrician, and the general surgeon, all of whom are often involved in these young patients' care. This article gives a practical approach to the child with abdominal pain and some information on acute appendicitis, which is the most common surgical cause of the acute abdomen in children.
Although the broad principles of diagnosis are the same as that in adult surgery, there are important variations. Diagnosis is often difficult, even for seasoned consultants, because signs can be subtle and non-specific, and young patients do not have an adult's ability to explain their distress. Correct diagnosis depends on good clinical judgment and experience.
The most important stepping stone towards a diagnosis is