Causes of acute pain in the abdomen of a child

The causes of the "acute abdomen": acute appendicitis: acute mechanical ileus; strangulated hernia; trauma of the abdominal cavity (rupture of the spleen, liver, intestine, cyst); adhesions after surgery on the organs of the abdominal cavity: tumor and inflammatory stenoses; invagination: obstruction by foreign bodies, including gallstones; diverticulitis; stomach and bowel ulcer; perforation; acute cholecystitis with peritonitis: torsion of the omentum, cysts, tumors; rupture of the fallopian tube in ectopic pregnancy; cardiovascular pathology (thrombosis of the mesenteric arteries, embolism of the aortic bifurcation or aortic aneurysm).

Signs of an "acute abdomen," which do not usually require surgical intervention, arise with acute pancreatitis, acute cholecystitis, acute gastritis, enterocolitis, diverticulitis, irritable colon, acute hepatitis, acute congestive liver, alcoholic hepatitis, hemochromatosis, nephrolithiasis, cystopyelitis, adnexitis, median pain, as well as with mesenteric lymphadenitis, tuberculosis, gonococcal, chlamydial peritonitis, with familial Mediterranean fever (periodic disease).

When examining a child with a syndrome of abdominal pain, attention should be paid to the attendant symptoms. Fever is a sign of infection or inflammation, tachycardia and hypotension - hypovolemia. If the patient is a girl of pubertal age who is in a state of shock, it is necessary to take into account the probability of torsion of the ovarian cyst, abortion, ectopic pregnancy. Hypertension may be a sign of vasculitis or hemolytic-uremic syndrome. The breathing of Kussmaul is characteristic of diabetic ketoacidosis.

Combination of the localization of pain with symptoms of irritation of the peritoneum and some other signs allows you to immediately select a group of diseases for differential diagnosis.

• Pain in the abdomen with the symptom of Shchetkin-Blumberg diffuse peritonitis. Spilled pain without symptom of Schetkin-Blumberg - acute ileus.
• Small intestine ileus (colic, vomiting, sunken abdomen with high ileus, flatulence - with low obstruction). It is necessary to examine the gates of possible hernias, exclude adhesive obstruction.
• Intestinal obstruction. Stool and gas retention, vomiting appears late.
• Pain in the epigastric region with irritation of the peritoneum - local peritonitis with perforation of the ulcer (abdomen as a board), acute pancreatitis (soft muscular protection).
• Pain in the epigastric region without irritation of the peritoneum - acute gastritis, pancreatitis, appendicitis debut (after a few hours the pain falls to the right downwards), pleuropneumonia, pericarditis, myocardial infarction, diabetic coma, collagenoses, porphyria, exfoliating aortic aneurysm.
• Pain in the peri-papular region with irritation of the peritoneum - serous peritonitis.
• Pain in the peripump region without irritation of the peritoneum - mechanical ileus, umbilical hernia, acute enterocolitis, irritated colon.
• Pain in the right upper quadrant with irritation of the peritoneum - acute cholecystitis, perforating or penetrating ulcer of the duodenum, acute pancreatitis, acute perihepatitis, acute appendicitis.
• Pain in the right hypochondrium without irritation of the peritoneum - cholelithiasis, liver abscess, acute congestive liver, hepatitis, right-sided pleuropneumonia, renal colic, shingles.
• Pain in the left hypochondrium with irritation of the peritoneum - perforation of the stomach ulcer, pancreatitis, rupture of the esophagus, rupture of the spleen.
• Pain in the left hypochondrium without irritation of the peritoneum - spleen infarction or other variants of lesion of the spleen and left kidney, pancreatitis, pleurisy, myocardial infarction, strangulated diaphragmatic hernia.
• Pain in the right iliac region with irritation of the peritoneum - acute appendicitis, adnexitis, rupture of the fallopian tube, torsion of the ovarian cyst.
• Pain in the right iliac region without irritation of the peritoneum - regional enteritis, acute ileitis, median pain, ovarian lesions, Meckelian diverticulitis, pancreatitis, pelvic venous thrombosis, inguinal hernia, cocksuit.
• Pain in the left iliac region with irritation of the peritoneum - acute diverticulitis.
• Pain in the left ileal region without irritation of the peritoneum - diverticulosis of the large intestine, irritated colon.
• Pain in the suprapubic region - acute retention of urine, exfoliating aneurysm of the aorta, acute thrombosis of the iliac vessels.

The most likely causes of abdominal pain in children of the first year of life

• Anomalies of development.
• Metoneal ileus.
• Necrotizing enterocolitis.
• Intussusception.
• Strangulated hernia.
• Gastroenteritis.
• Infantile colic.
• Constipation.
• Urinary tract infection.
• Hirschsprung's disease.

The most likely causes of abdominal pain in children aged 2-5 years

• Gastroenteritis.
• Appendicitis.
• Constipation.
• Urinary tract infection.
• Intussusception.
• Injury.
• Viral infections.
• Purple Shonlein-Genocha.
• Mesoadenitis.

The most likely causes of abdominal pain in children 6-11 years of age

• Gastroenteritis.
• Appendicitis.
• Constipation.
• Functional pain.
• Urinary tract infection.
• Injury.
• Viral infections.
• Purple Shonlyayna-Genocha.
• Mesoadenitis.

The most likely causes of abdominal pain in adolescents 12-18 years

• Appendicitis.
• Gastroenteritis.
• Constipation.
• Chololithiasis.
• Pancreatitis.
• Dysmenorrhea.
• Middle pains.
• Inflammatory pelvic disease.
• Abortion.
• Ectopic pregnancy.
• Torsion of testicles / ovaries.
• "Acute scrotum" (orchitis, trauma).

[1], [2], [3], [4], [5], [6]