Abdominal Pain In Pediatric Population Research Articles

Jejuno-jejunal Intussusception as an Unusual Cause of Acute Abdomen of a 26 Year Female - A Case Report

Intussusception is a relatively common etiology of abdominal pain in pediatric population. In adults, on the other hand, this entity is seen infrequently and a lead point can be recognized in a vast majority of cases. A 27 year old woman who was admitted in the Surgery Department of Shaheed Sohrawardy Medical College Hospital after experiencing severe upper abdominal pain associated with nausea, vomiting and fever. Later on the patient developed features of intestinal obstruction. Ultrasonography demonstrated small bowel intussusception. A jejunal intussusception 50 cm distal to the dudeno-jejunal junction was found during laparotomy. Resection and anasto mosis was performed as gut was not viable. A diagnosis of jejunal inflammatory fibroid polyp was made based on the histological findings which act as a lead point for jejunal intussusception.
 J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 111-114

My tummy hurts - a case report of abdominal pain and macrocytic anemia caused by hypothyroidism.

SummaryA 6-year-old female presented with chronic intermittent abdominal pain for 1 year. She underwent extensive investigation, imaging and invasive procedures with multiple emergency room visits. It caused a significant distress to the patient and the family with multiple missing days at school in addition to financial burden and emotional stress the child endured. When clinical picture was combined with laboratory finding of macrocytic anemia, a diagnosis of hypothyroidism was made. Although chronic abdominal pain in pediatric population is usually due to functional causes such as irritable bowel syndrome, abdominal migraine and functional abdominal pain. Hypothyroidism can have unusual presentation including abdominal pain. The literature on abdominal pain as the main presentation of thyroid disorder is limited. Pediatricians should exclude hypothyroidism in a patient who presents with chronic abdominal pain. Contrast to its treatment, clinical presentation of hypothyroidism can be diverse and challenging, leading to a delay in diagnosis and causing significant morbidity.Learning points:Hypothyroidism can have a wide range of clinical presentations that are often nonspecific, which can cause difficulty in diagnosis.In pediatric patients presenting with chronic abdominal pain as only symptom, hypothyroidism should be considered by the pediatricians and ruled out.In pediatric population, treatment of hypothyroidism varies depending on patients’ weight and age.Delay in diagnosis of hypothyroidism can cause significant morbidity and distress in pediatrics population.

An Interesting Cause of Mechanical Small Bowel Obstruction.

Foreign body ingestion is a known cause of abdominal pain in pediatric population occurring between 6months and 3years of age (Wyllie Curr Opin Pediatr 18:563, 2006, Uyemura Am Fam Physician 72:287, 2005, Banerjee Indian J Pediatr 72:173, 2005). Most of the ingested foreign bodies pass spontaneously with 10-20% requiring endoscopic retrieval, and <1% of cases require a surgical intervention (Wyllie Curr Opin Pediatr 18:563, 2006, Uyemura Am Fam Physician 72:287, 2005, Shivakumar Indian J Pediatr 71:689, 2004). Presence of intestinal obstruction necessitates surgical intervention to extract the ingested foreign body. Initial abdominal plain radiograph should be obtained when foreign body ingestion is suspected, which differentiates a radiopaque from radiolucent foreign bodies. A computed tomography with 3D reconstruction (3D-CT) is recommended with radiolucent foreign bodies (Uyemura Am Fam Physician 72:287, 2005, Kazam Am J Emerg Med 23:897, 2005). After 24h of expectant management, failure of spontaneous passage requires further intervention. Timely intervention to relieve the obstruction is pivotal to prevent undue complications. We present an interesting case of a boy who ingested a radiolucent foreign body diagnosed on 3D-CT, successfully treated with surgical extraction.