3. Detailed history about pain covering origin,
site , severity, timing, radiation etc.
Associated features like fever, vomiting,
diarrhea, constipation, dysuria, hemeturia,
dyspnoea, High colored urine etc.
History
4. General Physical
Examination
Pulse and vitals
Icterus, Pallor, Respiratory Distress
Fever/ Toxicity
Examination
5. Tenderness, Guarding,
Rigidity
Organomegaly/ Mass
P/A, Bowel Sounds
Per Rectal (P/R) &
Hernial Sites
Per Abdomen (P/A)
6. Hemodynamically unstable
patient
High fever & Toxicity
Abdominal Distension with
altered Bowel Sounds
Blood & Mucus after P/R
Rigidity & Mass Palpable in
Abdomen
Warning Signs in Acute
Abdominal Pain…
7. In small percentage of patients the child
presents with acute abdominal pain
repeatedly, the causes are …
Infantile colic
Renal Colic
Bacterial / Protozoal infections
Worm infestations
Peptic Ulcer Disease
T.B. Enteritis, Abd. Epilepsy etc.
Functional Pain Abdomen
Recurrent Acute
Abdominal Pain
8.
Magnitude of the
Problem
75% of Adolescents experience abdominal
pain
Nearly 15% school going children have pain
on weekly basis
BUT only 5-10% have Organic Cause
Recurrent Abdominal Pain
12. Organic & Functional
Pain Abdomen
Organic
Functional
1. Age 4-14 years
1.Age < 3 years 2.Dull Ache in Peri-
2.Localized pain in NON-
-Umbilical area
Peri-Umbilical area 3.No consistent duration
3.Awakens the Child from
frequency / periodicity
sleep 4.Pain for a brief time
4.Sudden, Severe Pain
associated with fever, pain free interval ranging
jaundice, dysuria, wt.loss, from days to weeks.
anorexia etc.
5.No fixed Point, No Radiation
5.Specific Physical Findings
6.Psychic Causes, Child
mass, rigidity, guarding. Personality, Behavior etc.
