A. Peritonitis
B. Appendicitis
C. Constipation
D. Urinary tract infection
E. Mesenteric lymphadenitis
F. Migraine
G. Intussusception
H. Henoch-Schonlein vasculitis
I. Psychosomatic
J. Shigella dysentry
For the following patients with abdominal pain, choose the most likely diagnosis.
1) A previously well 10 month old baby presenting with drawing up of her legs with crying and some bloody runny stools.
G. Intussusception
Note:
This is the right age group for intussception. It is often preceded by an URTI and it is thought that mesenteric lymphadenopathy may precipitate intussception. A red currant jelly-like stool is a late sign. In the older child, the cause of intussception may be HSP or lymphoma.
2) A 4-year-old child, with poor eating habits, iron deficiency anaemia and intermittent colicky abdominal pain.
C. Constipation
Note:
Constipation is common in children and should be managed aggressively to establish regular bowel habit quickly.
3) A 2-year-old girl with nephrotic syndrome who has developed a fever and abdominal pain.
A. Peritonitis
Note:
The causes of abdominal pain in nephrotic syndrome are peritonitis (usually pneumococcal), renal vein thrombosis and hypovolaemia.