Clinical spectrum of acute abdomen in children admitted to pediatric emergency department: A prospective study

Abstract

IntroductionAcute abdominal pain accounts for about 8% of all children attending the emergency department (ED) (Balachandran et al., 2013). In spite of being a common symptom seen in children, it is not uncommon for it to be a manifestation of a serious surgical emergency. There are inadequate published data from India regarding the spectrum of acute abdominal pain in children. ObjectiveThe objective of this study was to assess the clinical profile of children with nontraumatic acute abdominal pain admitted in the pediatric ED. MethodologyThis prospective observational study was conducted between June 2016 and July 2017. All the records of children aged between 2 and 18 years presenting with complaints of abdominal pain were collected in a predesigned proforma at the time of admission in the pediatric ED. Children who had undergone previous abdominal surgery and those with a history of trauma were excluded. ResultsA total of 720 children attending ED with complaints of abdominal pain were seen by the surgical team. According to their final diagnosis, they were divided into two groups: group I, 58 (8%; surgical); group II, 662 (92%; nonsurgical). Mean age of presentation was 7.5 ± 5.7 years; male-to-female ratio was 1.6:1. Detailed history and pain characteristics help in establishing the cause of pain. ConclusionThe cause of pain in more than 90% of children presenting in the pediatric ED with complaints of abdominal pain is nonsurgical. Constipation was the most common diagnosis in these children, followed by acute gastroenteritis. Only in 8% children, the cause of pain is surgical, and acute appendicitis is the most common surgical cause.