1: GI - Acute Abdomen Flashcards
What is problem with acute-abdomen in children under 8
- Abdominal pain is very non-specific in children. Hence there is a greater dependence on history to elicit factors
What may hard or no faeces indicate
Constipation
If someone who is afro-carribean has abdominal pain, what are the main concerns
Sickle cell crisis
what are causes of right and left hypochrondrium pain in children
URTI
Pneumonia
what can cause epigastric pain in children
GORD
how does hirschsprungs present
Painless abdominal distention
what can cause umbilical abdominal pain
- Intusussception
- Gastroenteritis
- DKA
- Sickle cell disease
- Functional
how does intussusception present
Colicky abdominal pain
Uncontrollable crying
what can cause flank pain in children
Pyelonephritis
what can cause right iliac fossa pain in children
Mesenteric adenitis
Appendicitis
Testicular and ovarian-torsion
how does mesenteric adenitis present in history
Often following tonsillitis
in which age-group is appendicitis rare
Under 5’s
[But if it does occur, common cause perforation]
what can cause left illiac-fossa pain
Meckel’s diverticulum
Constipation
what are ‘symptoms of acute abdomen’ in infants
- Crying
- Restlessness
- Drawing up of knees
when can children indicate site of pain
2-years
what are common causes of acute-abdomen in neonates
- Volvulus
- Necrotising enterocolitis
- Hirschsprung’s
- Meconium ileum
what are common causes of acute-abdomen in toddler’s
- Meckel’s
- Gastroenteritis
- Intussusception
- Volvulus
- Appendicitis
what are common causes of acute-abdomen in children and adolescents
- Appendicitis
- IBD
- Ovarian torsion
- Meckel’s diverticulum
- Pancreatitis
how does appendicitis present
Pain starts T10 then radiates to the right iliac-fossa
when is pain in appendicitis worse
on moving
what is mesenteric adenitis
enlargement lymph nodes within the mesentery
what is a distinguishing feature of mesenteric adenitis from appendicitis
often occurs following URTI
how is mesenteric adenitis diagnosed
laparoscopy: normal appendix and enlarged lymph nodes
when does mesenteric adenitis resolve
self resolve in 24-48h
what is meckel’s diverticulitis
congenital remnant of omphalomesenteric duct
how does meckel’s diverticulum present
- Abdominal pain that mimics appendicitis
- Rectal bleeding
- Intestinal obstruction
what is the main cause of large GI bleeds requiring transfusion in 1-2 year-olds
Meckel diverticulum
where does meckel diverticulum usually occur
2-feet from ileocaecal valve
how is meckel diverticulum managed
wedge excision or small bowel resection
