Acute Abdomen

Question 1

Medical causes of acute abdomen in children

Answer 1

Constipation

UTI

Coeliac disease
IBD

IBS

Mesenteric adenitis

Abdominal migraine

Pyelonephritis

Henoch-Schonlein purpura

Tonsilitis

Diabetic ketoacidosis

Infantile colic

Question 2

Causes of abdominal pain in adolescent girls

Answer 2

Dysmenorrhea (period pain)

Mittelschmerz (ovulation pain)

Ectopic pregnancy

Pelvic inflammatory disease

Ovarian torsion

Pregnancy

Question 3

Surgical causes of abdominal pain in children

Answer 3

Appendicitis

Intussusception

Bowel obstruction

Testicular torsion

Question 4

Describe appendicitis pain

Answer 4

Central abdominal pain spreading to right iliac fossa

Question 5

Describe intussusception pain

Answer 5

Colicky non-specific abdominal pain withredcurrantjelly stools

Question 6

Describe bowel obstruction pain

Answer 6

Pain, distention, absolute constipation and vomiting

Question 7

Describe testicular torsion pain

Answer 7

Sudden onset, unilateral testicular pain, nausea and vomiting

Question 8

Red flags for serious abdominal pain in children

Answer 8

Persistent or bilious vomiting

Severe chronic diarrhoea

Fever

Rectal bleeding

Weight loss or faltering growth

Dysphagia (difficulty swallowing)

Nighttime pain

Abdominal tenderness

Question 9

What is abdominal migraine?

Answer 9

May occur in young children before they develop traditional migraines as they get older

Presents with episodes ofcentral abdominal painlastingmore than 1 hour

Question 10

Management of acute attacks of abdominal migraine

Answer 10

Low stimulus environment (quiet, dark room)

Paracetamol

Ibuprofen

Sumatriptan

Question 11

Preventative medications for abdominal migraine

Answer 11

Pizotifen, a serotonin agonist (main)

Propranolol, a non-selective beta blocker

Cyproheptadine, an antihistamine

Flunarazine, a calcium channel blocker