Surgical causes of abdominal pain in children: a retrospective study

Abstract

INTRODUCTIONAbdominal pain is an important and common cause of hospital visit in paediatric patients. The anxiety of parents in most cases and the difficulty in obtaining history from children makes it difficult for the doctors to handle these patients. On an average about 5 to 10% of emergency department visit by children is attributable to abdominal pain.1 The presentation of abdominal pain can be acute or chronic. Among the acute causes some require urgent treatment while in others the treatment is nonurgent.It is a triage of sorts which helps in differentiating a serious condition from a benign one. Among the various causes, studies show that about 20% were of surgical etiology.2 Accurate diagnosis of cause of the pain is not possible with the assessment of the symptoms only because abdominal organs are devoid of pain sensation and the pain is usually a due to propagation of impulses to another area or due to visceral pain receptors activation.3,4 The management requires blood counts and urine analysis and is often supplemented with the judicial use of diagnostic modalities like ultrasound, abdomen X ray and CT scan when warranted. The diagnosis of acute appendicitis by only clinical examination has a sensitivity of 75% and specificity of 78% which is not satisfactory in clinical settings.5 This article analyses the common causes of abdomen pain in children and the treatment initiated.The aim of this study was to evaluate the various surgical causes of abdominal pain in children less than 15 yrs. We also evaluated the intervention given and the outcome. METHODSThis was a retrospective study in the department of surgery in our hospital during a period of 3 years from ABSTRACT Background: Abdominal pain is a very prevalent problem in children and one of the common causes for visit to the hospital. They may be of acute or chronic presentation and depending on severity may also require admission to hospital. Methods: This is a retrospective study conducted in our hospital over a period of 3 years. About 200 children who came to the hospital with abdominal pain and received treatment in surgical outpatient or referred to surgery department from emergency were included in this study and all relevant data were collected. Results: The pain was found to be more in boys and in the age group of 9 to 12years. The most common cause was found to be mesenteric adenitis followed by acute appendicitis. About 38% of children required surgical intervention on that admission due to various surgical causes. Conclusions:The database of our retrospective study regarding age and sex incidence, clinicopathological features and therapeutic outcome was comparable to other studies in various literatures.