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Abdominal Pain 

Abdominal Pain
Chapter:
Abdominal Pain
Source:
Acute Care Casebook
Author(s):

Peter Gutierrez

DOI:
10.1093/med/9780190865412.003.0060

This chapter is a review of the approach to pediatric abdominal pain, specifically the recognition, diagnosis, and management of appendicitis. Topics covered include red flag symptoms for abdominal pain in the pediatric patient, classic and nonclassic appendicitis presentations, and physical exam techniques that can help in the diagnosis of appendicitis. Also discussed is the Pediatric Appendicitis Score, which rates risk based on anorexia; nausea/emesis; migration of pain; fever (>38°C); pain with cough, percussion, or hopping; right lower quadrant tenderness; white blood cell count; and absolute band count. Middle risk assessment may require further imaging whereas high risk assessment can proceed immediately to surgery. The chapter also compares imaging modalities and reviews the literature for medical versus surgical management of appendicitis.

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