1) Between one-third to one-half of children admitted to the hospital for acute abdominal pain have non-specific abdominal pain, while another one-third have acute appendicitis. 2) A careful history, physical exam, and observation are important for evaluating acute abdominal pain in children. Additional tests like ultrasound, urine analysis, and bloodwork may also help diagnose conditions like UTIs, gastrointestinal issues, or appendicitis. 3) Non-specific abdominal pain is poorly localized, not worsened by movement, and rarely accompanied by guarding. It is usually self-limiting within 24 hours and may be caused by viral infections or transient intussusception.

1. Acute Abdominal Pain
Dr. Ashok Jaisingani

2. Introduction
► Between one-third to one-half of the child
admitted hospital for acute abdominal pain
have non-specific abdominal pain.
► Another one-third have acute appendicitis.
► Other relatively benign condition also cause
abdominal pain such as constipation, urinary
tract infection account for most of remain.

3. Work-up Of child with Acute
Abdominal Pain
► A careful history and examination and active observation
are paramount.
► Routine test include urine analysis, microscopy and culture.
► Frequently helpful tests such as abdominal ultrasound scan
can diagnose pelvic, UTI and GIT pathology.
► Occasionally helpful a plain supine radiograph particularly
in preschool child with pain and vomiting, urea and
electrolytes and CBC.
► Selective specific investigation are blood culture, stool
culture, plasma amylase and diagnostic laparoscopy.

4. Acute Non – Specific Abdominal Pain
► Pain is poorly localized, not aggravated by movement and
rarely accompanied by guarding.
► Site and severity of maximum tenderness often vary during
the course of repeated examination.
► Symptoms are usually self limiting within 24h.
► The etiology of non-specific pain in children is obscure but
viral infection and transitient intussusception are account
for some cases.
► Mesenteric adenitis a viral infection causing widespread
1- Reactive lymphadenopathy
2- Fever
3- Diffuse Abdominal Pain.

5. Other Causes Of Acute Abdominal
Pain
► Intestinal Obstruction
► Constipation
► Urinary Tract Infection
► Gastroenteritis
► Tropical Disease
► There are numerous rare cause of abdominal pain in
children are
1- Henoch-schonlen purpura
2- Sickle Cell Disease
3- Primary peritonitis, acute pancreatitis and biliary colic
4- Testicular torsion and gynecological pathology
5- Urinary stone disease.

6. Intestinal Obstruction
► Intestinalobstruction in children caused by
► Intussusception
► Inguinal Hernia
► Adhesion
► Meckel’s diverticulum

7. Constipation
► The passage of hard or infrequent stool.
► Constipation is more often cause acute
abdominal pain when it is secondary to
1- Anal Fissure
2- Hirschsprung’s Disease
3- Anorectal malformation
4- Neuropathic bowl.
► Rectal examination and plain abdominal
radiography may helpful in severe cases.

8. Urinary Tract Infection
► UTI is an uncommon cause of abdominal pain.
► Urinary symptoms vomiting and fever tend to be
predominant.
► Definitive infection can be confirmed by urinalysis,
microscopy and culture.
► Sterile pyuria may accompany acute appendicitis
► Child with pelviuretic junction obstruction present
with acute or recurrent abdominal pain with no
urinary symptoms.

9. Gastroenteritis
► Itmay cause colicky abdominal pain.
► Onset of pain before the diarrhea and
presence of lower abdominal tenderness
should raise suspicion of appendicitis.
► Pelvic tenderness on rectal examination may
be useful pointer to appendicitis.

10. Tropical Diseases
► Tropical Diseases causing acute abdominal
pain are
1- Ascariasis
2- Typhoid
3- Amoebiasis