Paeds Flashcards
What is a good rule to follow when assessing abdominal pain in children?
Rule out a urinary infection with urinalysis
This helps in identifying potential causes of abdominal pain.
What does ‘infant colic’ refer to?
Regular, unexplained periods of inconsolable crying in a well baby
Occurs usually in the late afternoon and evening, typically between 2 weeks and 16 weeks of age.
True or False: Infant colic occurs in babies with identifiable physical health issues.
False
Infant colic occurs in a well baby with no apparent cause for distress.
Fill in the blank: About one in ______ will have a surgical cause for abdominal pain.
15
This statistic emphasizes the need for proper assessment.
What organs are located in the right hypochondrium?
gall bladder, biliary tract, liver
List three conditions associated with the right hypochondrium.
- biliary colic
- cholecystitis
- acute hepatitis
What are the potential causes of periumbilical pain?
- jejunum/ileum
- appendix
- aorta
- small bowel obstruction
- gastroenteritis
- appendicitis (early)
- ruptured AAA
- mesenteric ischaemia
Which organs are involved in pain located in the right iliac fossa (RIF)?
- appendix
- caecum/ileum
- kidney/ureter
What are the common causes of pain in the groin area?
- torsion of testis
- hernial orifices (check with SBO)
Name the organs associated with epigastric pain.
- oesophagus
- stomach
- duodenum
- gall bladder
- liver
- pancreas
What serious conditions can cause left hypochondrium pain?
- kidney
- spleen
- urinary infection
- splenic infarct/rupture
What conditions can lead to lower abdominal pain?
- large bowel obstruction
- descending colon diverticulitis
- renal/ureteric colic
List the causes of suprapubic pain.
- ovaries
- ruptured ectopic
- fallopian tubes
- acute PID
- bladder
- ruptured ovarian cyst
- torsion of ovary
What are common causes of abdominal pain in children?
- infant ‘colic’
- gastroenteritis
- mesenteric adenitis
What serious conditions should not be missed in children with abdominal pain?
- intussusception
- acute appendicitis
- bowel obstruction/strangulated hernia
List some pitfalls in diagnosing abdominal pain in children.
- child abuse
- constipation/faecal impaction
- torsion of testes
- lactose intolerance
- peptic ulcer
- infections (e.g., mumps, tonsillitis, pneumonia, UTI)
- adnexal disorders in females
What are some rare causes of abdominal pain?
- Meckel diverticulitis
- Henoch-Schönlein purpura
- sickle crisis
- lead poisoning
What is included in the seven masquerades checklist for abdominal pain?
- type 1 diabetes
- drugs
- UTI
True or False: Psychogenic causes of abdominal pain in infants occur in about one-third of cases.
True
What are the clinical features of infant colic?
- Baby between 2 and 16 weeks old
- Prolonged crying (at least 3 hours)
- Occurrence at least 3 days a week
- Crying worst at around 10 weeks of age
- Crying during late afternoon and early evening
- Child flexing legs and clenching fists
- Normal physical examination
Fill in the blank: Management of infant colic includes reassurance and explanation, and advising parents to use _______.
gentleness
What is intussusception?
A condition where a segment of bowel telescopes into the adjoining distal segment, causing intestinal obstruction.
It is usually idiopathic but may have a pathological lead point.
What age group is most commonly affected by intussusception?
Children aged between 3 months and 2 years, typically 5-24 months.
Male babies are more frequently affected than female babies.
What are the typical clinical features of intussusception?
- Sudden-onset acute pain with a shrill cry
- Vomiting
- Lethargy
- Pallor with attacks
- Intestinal bleeding: redcurrant jelly
60% of patients present with redcurrant jelly stools.
