Pediatric Abdominal Pain Causes

Aka: Pediatric Abdominal Pain Causes, Abdominal Pain Causes in Children

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II. Causes: All Ages (common or important)

  1. Surgical conditions
    1. Appendicitis
    2. Bowel Obstruction
    3. Gallbladder disease (Biliary Colic, Cholecystitis)
    4. Abdominal Trauma
  2. Other high risk conditions
    1. Child Abuse
    2. Hemolytic Uremic Syndrome
    3. Pancreatitis
    4. Sickle Cell Crisis
    5. Pyelonephritis (or Urinary Tract Infection)
    6. Diabetic Ketoacidosis
    7. Henoch-Schonlein-Purpura (HSP)
  3. Functional or self limited
    1. Constipation
    2. Dietary indiscretion
    3. Gastroenteritis
    4. Mesenteric Lymphadenitis
    5. Upper Respiratory Infection

III. Causes: Neonatal or Infant (<1 year)

  1. Also see Infant, toddler and preschool causes below
  2. Surgical or serious conditions
    1. Intestinal Malrotation or Midgut Volvulus
    2. Necrotizing Enterocolitis
    3. Hirschprung's Enterocolitis
    4. Testicular Torsion (especially in Undescended Testicle)
    5. Incarcerated Hernia
    6. Pyloric Stenosis (Vomiting)
  3. Functional, self-limited or easily managed
    1. Infantile Colic
    2. Milk Protein Allergy
    3. Pediatric Gastroesophageal Reflux

IV. Causes: Infant, toddler and preschool (age 1 to 5 years old)

  1. Miscellaneous Important causes
    1. Intussusception
    2. Intestinal Malrotation or Midgut Volvulus
    3. Pyelonephritis (or Urinary Tract Infection)
    4. Lead Poisoning
    5. Foreign Body Ingestion
    6. Meckel Diverticulum
    7. Diabetic Ketoacidosis
  2. Bowel Obstruction
    1. Pyloric Stenosis
    2. Incarcerated Hernia
    3. Internal Hernia
    4. Omphalomesenteric band
    5. Hirschprung's Disease
  3. Non-accidental Trauma (or Battered Infant)
    1. Duodenal Hematoma (classic presentation)
    2. Jejunum perforation
    3. Duodenal transection
  4. Functional or self-limited
    1. Gastroenteritis
    2. Constipation

V. Causes: School-Aged Child (ages 5 to 11 years old)

  1. Miscellaneous serious causes
    1. Intussusception or Volvulus (children under age 6)
    2. Abdominal Trauma
    3. Sickle Cell Crisis
    4. Henoch-Schonlein Purpura
    5. Appendicitis
    6. Pyelonephritis or Urinary Tract Infection
    7. Pneumonia
    8. Acute Pancreatitis
    9. Lead Poisoning
    10. Diabetic Ketoacidosis
    11. Inflammatory Bowel Disease
    12. Testicular Torsion or Ovarian Torsion
  2. Hernia
    1. Inguinal Hernia occurs in 5% of pediatric patients
    2. Ovary Herniate
  3. Bowel Obstruction
    1. Prior abdominal surgery
    2. Abdominal masses (e.g. Wilm's Tumor in toddlers, Neuroblastoma)
  4. Gall Bladder disorder
    1. TPN Cholestasis
    2. Sickle Cell Anemia
    3. Morbid Childhood Obesity
  5. Benign or self-limited causes (or easily treated)
    1. See Functional Abdominal Pain in Children
    2. Mesenteric Lymphadenitis (difficult to distinguish from Acute Appendicitis)
    3. Gastroenteritis
    4. Pharyngitis (e.g. Strep Throat)
    5. Constipation
    6. Lactose Intolerance
    7. Helicobacter Pylori
    8. Abdominal Migraine
    9. Mononucleosis

VI. Causes: Adolescent (age 12 to 18 years)

  1. Surgical and serious causes
    1. Appendicitis
    2. Testicular Torsion
    3. See Gallbladder disease above
  2. Gynecologic cause
    1. Pregnancy (or Ectopic Pregnancy)
    2. Mittelschmerz
    3. Dysmenorrhea
    4. Pelvic Inflammatory Disease (or Tubo-Ovarian Abscess)
    5. Ovarian Torsion
    6. Imperforate Hymen
  3. Miscellaneous important causes
    1. Drug and Alcohol use
    2. Sexual abuse
    3. Neoplasm
    4. Inflammatory Bowel Disease
    5. Nephrolithiasis
    6. Pyelonephritis or Urinary Tract Infection
    7. Sexually Transmitted Infection
  4. Benign or self limited conditions
    1. See Functional Abdominal Pain in Children
    2. Gastroenteritis
    3. Constipation
    4. Mononucleosis
    5. Abdominal Migraine
    6. Irritable Bowel Syndrome

VII. References

  1. Herbert (2012) EM:RAP - C3 Project 2(3):1
  2. Buel (2024) Am Fam Physician 110(6): 621-31 [PubMed]
  3. Hijaz (2017) Pediatr Health Med Ther 8:83-91 +PMID: 29388612 [PubMed]
  4. Leung (2003) Am Fam Physician 67(11):2321-6 [PubMed]

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Related Studies

Ontology: Abdominal Pain (C0000737)

Definition (MSHCZE) Pocit nevolnosti, obtíží nebo bolesti v břišní oblasti; obvykle při funkčních poruchách, tkáňových poraněních nebo nemocech.
Definition (MEDLINEPLUS)

Your abdomen extends from below your chest to your groin. Some people call it the stomach, but your abdomen contains many other important organs. Pain in the abdomen can come from any one of them. The pain may start somewhere else, such as your chest. Severe pain doesn't always mean a serious problem. Nor does mild pain mean a problem is not serious.

Call your healthcare provider if mild pain lasts a week or more or if you have pain with other symptoms. Get medical help immediately if

  • You have abdominal pain that is sudden and sharp
  • You also have pain in your chest, neck or shoulder
  • You're vomiting blood or have blood in your stool
  • Your abdomen is stiff, hard and tender to touch
  • You can't move your bowels, especially if you're also vomiting
Definition (NCI_CTCAE) A disorder characterized by a sensation of marked discomfort in the abdominal region.
Definition (NCI) Painful sensation in the abdominal region.
Definition (MSH) Sensation of discomfort, distress, or agony in the abdominal region; generally associated with functional disorders, tissue injuries, or diseases.
Concepts Sign or Symptom (T184)
MSH D015746 , D003085
ICD9 789.00, 789.0
ICD10 R10.9
SnomedCT 207205003, 207230000, 158498003, 158512003, 139313005, 21522001
LNC MTHU013636, LA15468-4
English Abdominal Pains, Pains, Abdominal, Abdominal pain NOS, Abdominal Pain, [D]Abdominal pain (context-dependent category), [D]Abdominal pain NOS (context-dependent category), Abdo pain, Pain abdo, Abd. pain, [D]Abdominal pain, [D]Abdominal pain NOS, abdominal pain (symptom), abdominal pain, Pain abdominal, Gut pain, Abdmnal pain unspcf site, Unspecified abdominal pain, Abdominal Pain [Disease/Finding], Pain;abdominal, gut pain, abdomen pain, abdominal pains, Bellyache, Pain, Abdominal, Abdomen pain, [D]Abdominal pain (situation), [D]Abdominal pain NOS (situation), ABDOMINAL PAIN, PAIN, ABDOMINAL, Abdominal pain, AP - Abdominal pain, Abdominal pain (finding), abdominal; pain, abdominalgia, pain; abdominal, Abdominal pain, unspecified site
French DOULEUR ABDOMINALE, Douleur abdominale SAI, Douleur intestinale, Douleur abdo, Douleur abdo., Douleur abd., Colique, Douleur abdominale, Douleur de l'abdomen
Portuguese DOR ABDOMINAL, Dor abdominal NE, Dor intestinal, Câimbras Abdominais, Cólicas, Câimbra Abdominal, Cãibra Abdominal, Dor abdominal, Cólica, Dor Abdominal
Dutch darmpijn, buikpijn NAO, pijn abdominaal, abdominaal; pijn, pijn; abdominaal, abdominale pijn, Buikpijn, Pijn, buik-
German Schmerz abdominal, Bauchschmerz, abd. Schmerz, Abdominalschmerzen NNB, Schmerz abdo, abdo. Schmerz, ABDOMEN SCHMERZHAFT, Abdominalschmerz, Abdominalschmerzen, Bauchschmerzen, Kolik
Italian Dolore intestinale, Dolore addominale NAS, Dolore colico, Colica, Dolore addominale
Spanish Dolor de barriga, Dolor abdominal NEOM, [D]dolor abdominal, SAI (categoría dependiente del contexto), [D]dolor abdominal (categoría dependiente del contexto), ABDOMEN, DOLOR, [D]dolor abdominal (situación), [D]dolor abdominal, SAI (situación), [D]dolor abdominal, [D]dolor abdominal, SAI, dolor abdominal (hallazgo), dolor abdominal, Dolor abdominal, Dolor Abdominal
Japanese 腸管痛, 腹痛ＮＯＳ, 腹痛, ﾌｸﾂｳ, ﾁｮｳｶﾝﾂｳ, ﾌｸﾂｳNOS, 疝痛, 腹部痙攣, 仙痛, 腹部けいれん
Swedish Buksmärta
Czech kolika, Břišní bolest NOS, Střevní bolest, Bolest břicha, bolesti břicha, břicho - bolest
Finnish Koliikki, Vatsakipu
Russian BRIUSHNAIA POLOST', BOLI, ABDOMINAL'NAIA BOL', KOLIKA, ABDOMINAL'NYI SPAZM, АБДОМИНАЛЬНАЯ БОЛЬ, АБДОМИНАЛЬНЫЙ СПАЗМ, БРЮШНАЯ ПОЛОСТЬ, БОЛИ
Croatian ABDOMINALNA BOL
Polish Ból brzucha
Hungarian Hasi fájdalom, Abdominalis fájdalom k.m.n., Bél fájdalom, Abdominalis fájdalom, Hasfájdalom
Norwegian Kolikksmerter, Magesmerter, Kolikk, Abdominalsmerter, Magesmerte
Derived from the NIH UMLS (Unified Medical Language System)

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