paediatric acute abdomen

Question 1

A six month old infant presents to the Accident & Emergency Department with a 12hour history of sudden bouts of screaming and drawing up of his legs. He has passed one mucousy, blood-stained stool over this time.

Dx?

Answer 1

intussusception

Question 2

A child of 6 years presents with a 24 hour history of intermittent central abdominal pain and has vomited 6-
8 times. Her mother tells you that she had a bad cold about 10 days earlier. On examination her temperature is 38.5˚C. She is flushed.

Dx?

Answer 2

mesenteric adenitis

Question 3

A 3 year old boy presents with abdominal pain which appears to be intermittent and makes him cry. His mother volunteers that he has not had a bowel motion for 4 days.

Dx?

Answer 3

constipation

Question 4

An 18 month old child comes to the casualty department, crying with abdominal pain. His mother tells you that she has been like this for 2 days. She also says that she has been vomiting frequently, and has had 3 very loose stools. An older sibling had something similar last week.

Dx?

Answer 4

gastroenteritis

Question 5

A 10 year old presents to his GP with a 2day history of abdominal pain, which he says is in the centre of his “tummy”. The pain has now moved into the right iliac fossa. On examination he is tender, with guarding in the right iliac fossa.

Dx?

Answer 5

acute appendicitis