ACUTE ABDOMINAL PAIN IN CHILDREN

CLINICAL OUTCOMES & VALUE OF SYMPTOMS AND SIGNS IN DIAGNOSIS

Abstract

Objective: To determine the clinical outcomes of acute abdominal pain and
evaluation of symptoms and signs in children admitted in pediatric surgery department.
Design: Cohort study. Place and Duration of study: This study was conducted in Department
of Paediatric Surgery Shaikh Zayed Hospital, Lahore between August 2010 to August 2012.
Patients and methods: Children aged 2 to 14 years who presented to emergency department
with complaint of acute abdominal pain of less than 5 days duration and admitted in pediatric
surgery department were included. Presenting symptoms, signs, hospital course of patients
and discharge diagnosis were recoded. Data was analyzed by SPSS. Results: Out of 73104
patients who were seen in Paediatric emergency 1420 (1.94%) were referred for surgical
evaluation. Out of these 157 children were admitted. Six patients left against medical advice
so 151 patients were studied. Patients were divided into acute appendicitis, non-specific
pain abdomen and miscellaneous categories on the basis of discharge diagnosis. Acute
appendicitis was diagnosed in 61(40.4%) patients. The patients who were admitted and no
cause of pain abdomen could be found in them, were included in non-specific pain abdomen
group. NSPA group had 39 (25.8%) patients. Rests of the 51 (33.8%) patients were included
in miscellaneous group. Anorexia, fever, pain in right lower quadrant, tenderness in right iliac
fossa, guarding, rebound tenderness and tachycardia were all significantly higher in patients
with acute appendicitis. Conclusion: Most of the children with acute abdominal pain would
not require surgery. Detailed history and thorough physical examination are cornerstone of the
diagnosis.