Abdominal Pain
نویسنده
چکیده
Acute abdominal pain is a popular descriptor that has evolved from the seminal definition by Sir Zachary Cope of abdominal pain of recent onset that triggers an urgent need for prompt diagnosis and active treatment.1 The nature of the pain is usually such that the parent seeks immediate medical evaluation by a general pediatrician or emergency room physician. An acute complaint of abdominal pain precipitates at least 5% of unscheduled pediatric visits.2 Although most children with acute abdominal pain have self-limiting conditions, the pain may herald a serious medical or surgical emergency. The diverse etiologies include acute surgical emergencies, disorders that will or may require surgical intervention, and specific intraabdominal, extraintestinal, or systemic medical disorders. Severe acute pain may also present against a background of chronic illness. Most often, the child appears well at presentation, and the abdominal pain is accompanied by multiple complaints and is usually associated with a selflimited disease. The major challenge is to make a timely diagnosis of the acute surgical abdomen. In patients who present with acute abdominal pain to a primary care practice or community emergency room, the frequency of diseases requiring surgical intervention may be as low as 1%.2 A physician can easily become complacent when dealing with a child with acute pain. It is important to have a consistent approach that addresses key diagnostic categories and gives parents guidelines to recognize warning signs that require re-evaluation. The primary care physician or emergency physician will most often call on the pediatric or general surgeon for consultation when concerned about a particular presentation of acute abdominal pain. There are, however, occasions when, with indefinite symptoms, there may be a tendency to wait for evolution of an acute process, in which case, the pediatric gastroenterologist may become involved in diagnosis and management.
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تاریخ انتشار 2012