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

  1. 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
  2. Functional, self-limited or easily managed
    1. Colic
    2. Milk Protein Allergy
    3. Gastroesophageal Reflux

IV. Causes: Infant, toddler and preschool (<5 years old)

  1. Miscellaneous Important causes
    1. Intussusception
    2. Intestinal Malrotation or Midgut Volvulus
    3. Pyelonephritis (or Urinary Tract Infection)
    4. Lead Poisoning
  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. Infantile Colic
    2. Gastroenteritis
    3. Constipation

V. Causes: 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. Pancreatitis
    9. Lead Poisoning
  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 Obesity
  5. Benign or self-limited causes (or easily treated)
    1. Mesenteric Lymphadenitis
    2. Gastroenteritis
    3. Pharyngitis (e.g. Strep Throat)
    4. Functional Abdominal Pain in Children
    5. Constipation
    6. Lactose Intolerance
    7. Helicobacter Pylori

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
    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
  4. Benign or self limited conditions
    1. Gastroenteritis
    2. Constipation
    3. Mononucleosis

VII. References

  1. Majoewsky (2012) EM:RAP - C3 Project 2(3):1
  2. Leung (2003) Am Fam Physician 67(11):2321-6 [PubMed]

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