Acute abdominal pain in children; clinical outcomes and value of symptoms and signs in diagnosis

ABSTRACT

To determine the clinical outcomes of acute abdominal pain and evaluation of symptoms and signs in children admitted in pediatric surgery department. Cohort study. This study was conducted in Department of Paediatric Surgery Shaikh Zayed Hospital, Lahore between August 2010 to August 2012. 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. 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. Most of the children with acute abdominal pain would not require surgery. Detailed history and thorough physical examination is cornerstone of the diagnosis