Nonspecific abdominal pain is a safe diagnosis

Abstract

AimThe aim of this study is to assess if a clinical diagnosis of nonspecific abdominal pain (NSAP) is safe and if patients with this initial diagnosis are likely to require further investigation or surgical intervention. Methods3323 patients admitted with NSAP from July 1990 to September 2012 utilizing a prospective database of all surgical admissions were included. Readmission over the period of the study and specifically within 30days of their initial presentation was identified together with any invasive investigation or surgical intervention. Main results319 children (9.6%) were subsequently readmitted with abdominal pain at some point during the study period. Of these, 78 (2.3%) were readmitted within 30days. 118 (3.5%) children subsequently had an operation or invasive investigation some point following their initial admission. Of these 33 (0.6%) had the procedure within 3months of the initial admission. 13 patients had an appendicectomy within 3months of the initial presentation. Of these histology confirmed appendicitis in 8 patients. This gives an overall incidence of “missed” appendicitis of 0.2 % (8/3323). ConclusionThis study confirms that a clinical diagnosis of nonspecific abdominal pain (NSAP) is safe in a pediatric population and the risk of “missing” appendicitis is only 0.2%. Patients and/or parents can be confidently reassured that the risk of missing organic pathology is very low.