Keterangan
Pediatric abdominal pain is a common complaint encountered in clinical practice, often causing significant distress to both children and their parents. Abdominal pain in children can be challenging to diagnose and manage due to the wide range of possible causes. Understanding the underlying etiology of pediatric abdominal pain is crucial for appropriate management. The most common causes of pediatric abdominal pain include gastroenteritis, constipation, urinary tract infections, and functional abdominal pain. Inflammatory conditions such as appendicitis, pancreatitis, and inflammatory bowel disease should also be considered. A thorough history and physical examination are essential in the evaluation of pediatric abdominal pain. The location, duration, and characteristics of the pain can provide valuable clues to the underlying cause. In cases of gastroenteritis, supportive care with fluid replacement and symptomatic relief is usually sufficient.
Ringkasan
- Abdominal pain can originate from various sources, including neurogenic, vasculogenic, intermission, or psychogenic factors. Visceral pain, often associated with internal organs, is poorly localized and accompanied by symptoms like vomiting and sweating. In contrast, parietal pain is more localized and severe. Pain in solid organs like the liver or spleen is typically dull, while pain in hollow organs like the intestines is sharp.
- The abdominal organs derive from the foregut, midgut, and hindgut, each with a common afferent visceral nerve supply. Visceral pain is associated with specific anatomical regions, such as periumbilical pain originating from midgut-derived organs. The location and nature of the pain can provide clues to the underlying cause.
- Acute abdominal pain lasts for a shorter duration, typically two to three weeks, while chronic pain persists for longer periods. Detailed history taking is essential, including the onset, duration, and relieving or aggravating factors of the pain. Associated symptoms like vomiting, fever, or changes in bowel habits should be noted.
- When examining a child with abdominal pain, consider abdominal distention, organomegaly, and tenderness. It's important to assess the entire gastrointestinal system, from the oral cavity to the anal opening, for potential sources of pain. Be vigilant for signs of danger such as low blood pressure and altered mental status.
- Differential diagnoses for abdominal pain vary with age and clinical presentation. In infants, consider intussusception or cow's milk protein allergy. In older children, inflammatory bowel disease or constipation are possibilities. Always check the testicles in male children, as testicular torsion can present as abdominal pain.
- Investigations for abdominal pain should be guided by the clinical picture and differential diagnosis. Sonography can be useful for visualizing abdominal organs, while CT scans or MRIs may be necessary for more detailed evaluation. Stool cultures are typically not helpful in acute cases.
- Management of abdominal pain includes symptomatic relief with antispasmodics and analgesics, as well as addressing any underlying causes. Hydration and home remedies can also be helpful. Surgical intervention may be necessary in certain cases. A systematic approach to history, examination, and investigation is crucial for accurate diagnosis and effective management of abdominal pain in children.
Contoh Sertifikat
Tentang Pembicara
Dr. Vishal Parmar
Specialist Pediatrician and Neonatologist Borivali, Mumbai.
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