CHRONIC ABDOMINAL NAZURAH ROSLAN

M141091034
PAIN IN CHILD
WHAT IS CHRONIC?
CHRONIC IS OFTEN DEFINED
AS ANY PAIN LASTING MORE
THAN 12 WEEKS.
ACUTE PAIN LASTS SEVERAL HOURS TO DAYS WHILE
CHRONIC PAIN CAN LAST FROM DAYS TO WEEKS TO
MONTHS
DEFINITION
Abdominal pain in a child is one of the most common
presentations with both trivial and life threatening etiologies,
ranging from functional pain to acute appendicitis.
The majority of pediatric abdominal complaints are relatively
benign (e.g. constipation), but it is important to pick up on the
cardinal signs that might suggest a more serious underlying
disease.
Diagnosing abdominal pain in children is also a challenging task.
Conditions vary amongst age groups ( i.e. volvulus in neonates,
intussusception in toddlers)
CAUSES OF ABDOMINAL
PAIN
NOT LIFE THREATING LIFE THREATING

Constipation Appendicitis
Gas Gallstones

Food allergy or intolerance Stomach ulcer

Heartburn or acid reflux Hernia or other bowel twisting, blockage or obstruction

Stomach flu or food poisoning Inflammatory bowel disease (Crohn's disease or

ulcerative colitis)

Strep throat or mononucleosis ("mono") Intussusception, caused by part of the intestine being
pulled inward into itself

Colic Sickle cell disease crisis

Air swallowing Stomach ulcer

Torsion (twisting) of the testicle
Torsion (twisting) of the ovary

Abdominal migraine Tumour or cancer

Urinary tract infection
SIGN AND SYMPTOMS
Nausea
Bilious vomiting
Vomitting Bloody stool or emesis
Night time waking with abdominal pain
Diarrhea Hemodynamic instability
Loss of appetite Weight loss

Fluid losses
Constipation
DIAGNOSIS
o Full blood count.
- can be helpful in the child with anemia and can reveal
hemoconcentration in the dehydration child
- an elevated white blood cell count may help to diagnose the
child if he has an infection

oUrinalysis
-assessing dehydration or providing evidence of infection or
genitourinary disease
DIAGNOSIS
Abdomen X-Ray
- radiographs may suggest conditions such as mass,
intussusception or medial displacement of the stomach bubble
from splenic hematoma.

Collection of stool
-with the help of a bag placed around the anus, using an inverted
diaper or insertion of a rectal tube to collect stool sample are
practical ways to confirm the watery nature of stool and also to
obtain samples for investigations.
MANAGEMENT
If the children is hemodynamically unstable because of the fluid
losses, immediately intravenous access and fluid resuscitation are
given.
Further stabilization may require gastric decompression with
nasogastric tube aspiration
Foley catheter insertion for monitoring urine output and collecting
specimen
Appropriate antibiotic coverage or initial treatment of ingested
toxin should be considered.
REFERENCE
Book
1. Hussain Imam Hj Muhammad Ismail. Paediatric Protocols For Malaysian
Hospital, Suria Time Entreprise, Pages 367-369
2. Pervez Akhbar K. Basis of Paediatric, Paramount Books LTD, 2015. Pages
313-314
.
.Website
.https://medlineplus.gov/magazine/issues/spring11/articles/spring11pg
5-6.html
THANK YOU