Abdominal Pain

2018 ◽  
pp. 295-299
Author(s):  
Peter Gutierrez

This chapter is a review of the approach to pediatric abdominal pain, specifically the recognition, diagnosis, and management of appendicitis. Topics covered include red flag symptoms for abdominal pain in the pediatric patient, classic and nonclassic appendicitis presentations, and physical exam techniques that can help in the diagnosis of appendicitis. Also discussed is the Pediatric Appendicitis Score, which rates risk based on anorexia; nausea/emesis; migration of pain; fever (>38°C); pain with cough, percussion, or hopping; right lower quadrant tenderness; white blood cell count; and absolute band count. Middle risk assessment may require further imaging whereas high risk assessment can proceed immediately to surgery. The chapter also compares imaging modalities and reviews the literature for medical versus surgical management of appendicitis.

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Floris B Poelmann ◽  
Ewoud H Jutte ◽  
Jean Pierre E N Pierie

Abstract Intestinal obstruction caused by pericecal internal herniation are rare and only described in a few cases. This case describes an 80-year-old man presented with acute abdominal pain, nausea and vomiting, with no prior surgical history. Computed tomography was performed and showed a closed loop short bowel obstruction in the right lower quadrant and ascites. Laparoscopy revealed pericecal internal hernia. This is a viscous protrusion through a defect in the peritoneal cavity. Current operative treatment modalities include minimally invasive surgery. Laparoscopic repair of internal herniation is possible and feasible in experienced hands. It must be included in the differential diagnoses of every patient who presents with abdominal pain. When diagnosed act quick and thorough and expeditiously. Treatment preference should be a laparoscopic procedure.


2021 ◽  
Vol 14 (7) ◽  
pp. e242523
Author(s):  
Samer Al-Dury ◽  
Mohammad Khalil ◽  
Riadh Sadik ◽  
Per Hedenström

We present a case of a 41-year-old woman who visited the emergency department (ED) with acute abdomen. She was diagnosed with perforated appendicitis and abscess formation on CT. She was treated conservatively with antibiotics and discharged. On control CT 3 months later, the appendix had healed, but signs of thickening of the terminal ileum were noticed and colonoscopy was performed, which was uneventful and showed no signs of inflammation. Twelve hours later, she developed pain in the right lower quadrant, followed by fever, and visited the ED. Physical examination and blood work showed signs consistent with acute appendicitis, and appendectomy was performed laparoscopically 6 hours later. The patient recovered remarkably shortly afterwards. Whether colonoscopy resulted in de novo appendicitis or exacerbated an already existing inflammation remains unknown. However, endoscopists should be aware of this rare, yet serious complication and consider it in the workup of post-colonoscopy abdominal pain.


1999 ◽  
Vol 16 (5) ◽  
pp. 441-444 ◽  
Author(s):  
Kazuya Kato ◽  
Minoru Matsuda ◽  
Kazuhiko Onodera ◽  
Hiromi Sakata ◽  
Tatsuo Kobayashi ◽  
...  

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