Recurrent Abdominal Pain in Children

THIS paper is an atteimpt to elucidate the common causes of recurrent abdominal pain in childhood of more than a transient nature, and consists of an investigation of all cases admitted to the Belfast Hospital for Sick Children during the years 1934, 1935, and 1936, whose abdominal symptoms were of such a character as to be considered worthy of laparotomy. There are 134 cases in all, 130 have been traced since operation, and of these all except five have been personally interviewed and examined; of the four cases untraced, one had removed to an unknown address in England, two others to unknown addresses in Belfast, and the last one died on the evening of operation. Of the five cases traced without personal examination, reports have been received concerning their present welfare, anid here I should like to acknowledge the valuable help and cooperation of three colleagues in furnishing reports, one from Derry, one from Dublin, and one from Donegal The period elapsing since operation has, of course, varied greatly; the work for this paper was not commenced till near-the end of 1936, and vet includes all cases from the commencement of 1934; but no patienit was reexamined in less time than six months after operation, as it was felt that less than tlis wxould not give a reasonable trial of the treatment adopted. Of the 13-t cases, forty-four wxere admitted in 1934, thirty-six in 1935, and fifty-four in 1936; ancl of the total, sixty-three were males andcl seventy-oine femiiales. The ages varied from 21 years to 144 years, with an average of 9 J, years. The total time in hospital for the 134 cases was 2,315 days, averaging 17.27 days from admission to discharge, or 13.7 days after operatioil. This latter figure may give a false impression of length of time, as the majority were under this figure, the aveerage beinig raised by uncertain pathology in several patients whose abdominal incision varied from the usual gridiron being either paramedian or split rectus, with a proportionately longer time for healing. The former figure, too, may seem rather high, but in several cases the type of symptoms suggested varying situations for the pathology, necessitating investigation as in-patients; onie patient was a diabetic and required a period of six weeks for diet standardisation before operation. The large majority of cases were seen at the surgical outpatient department , and most of the investigatioi …