DIAGNOSIS AND TREATMENT: RECURRENT ABDOMINAL PAIN IN CHILDREN—A SURGEON'S VIEWPOINT

PEDIATRICS ◽  
1967 ◽  
Vol 40 (6) ◽  
pp. 1024-1026
Author(s):  
Donald G. Marshall
Keyword(s):  
Abdominal Pain ◽  
Physical Examination ◽  
Recent Article ◽  
Recurrent Abdominal Pain ◽  
Diagnosis And Treatment ◽  
Subsequent Paper ◽  
Organic Disease ◽  
Detailed History ◽  
Psychogenic Pain ◽  
Complete Physical Examination

MUCH has been written in recent years about the importance of psychogenic disturbances as causes of abdominal pain in childhood. Yet, by no means all recurrent abdominal pain is so caused. A recent article in Pediatrics on nonorganic abdominal pain therefore promised this subsequent paper on pain of organic origin. I would like to caution the reader that his "surgeon's viewpoint" tends to exclude consideration of organic abdominal pain not surgically treated. Perhaps a third paper is indicated. Abdominal pain of whatever origin requires a planned approach to diagnosis. While it is only too easy for the clinician to submit a patient to innumerable investigations of varying degrees of unlikelihood of revealing disorders of differing degrees of rarity, a detailed history and searching interview with the parents, together with a complete physical examination, will go very far to reduce the number of cases submitted to any but quite simple tests. The diagnosis of psychogenic pain, no less than that of organic pain, must rest on positive findings. To make a diagnosis of psychogenic pain, there must be something more than the absence of demonstrable organic disease. There must be significant psychopathology. If there is evidence of neither this nor organic disease, one must resolve to be irresolute and decide to be undecided. One must not make a diagnosis of psychic disease simply because one can find no organic cause. One must also remember that psychic disturbance does not confer immunity from organic disease. A neurotic, psychotic, or brain-damaged child can have appendicitis.

Abdominal Pain

2021 ◽  
Keyword(s):  
Abdominal Pain ◽  
Physical Examination ◽  
Recurrent Abdominal Pain ◽  
Organic Disease ◽  
Functional Abdominal Pain ◽  
Medical Evaluation ◽  
Key Points ◽  
Common Causes ◽  
Rome Iv

Key Points Functional abdominal pain disorders are the most common causes of recurrent abdominal pain in pediatrics.The Rome IV criteria in 2016 for functional abdominal pain have eliminated the requirement of "no evidence for organic disease"; it now is defined as > 2 months of pain, ≥ 4 times per month, and after appropriate medical evaluation the symptoms cannot be attributed to another medical condition.History and physical examination are the only evaluations required most of the time in a child with abdominal pain.

scholarly journals A Case of Hereditary Pancreatitis Presenting as Recurrent Abdominal Pain in a 11 Year Old Girl

2015 ◽  
Vol 35 (1) ◽  
pp. 57-58
Author(s):  
A Das ◽  
M Basu
Keyword(s):  
Abdominal Pain ◽  
Physical Examination ◽  
Recurrent Abdominal Pain ◽  
Organic Disease ◽  
Hereditary Pancreatitis ◽  
History Of ◽  
Complete History

Recurrent abdominal pain is a common problem among children. Since its first description by John Apley in 1958, the condition has remained poorly understood with a multitude of factors being implicated in causation. The symptoms tend to be vague and investigations seldom show organic disease. But the importance to evaluate each child with recurrent abdominal pain should be considered important nevertheless, particularly, in protracted cases. Here, we present a case who presented with history of recurrent abdominal pain for several years before being diagnosed as a case of hereditary pancreatitis. This stresses the importance of evaluating each case with a detailed and complete history, physical examination and selected investigations.J Nepal Paediatr Soc 2015;35(1):57-58

Children with Fevers: II

PEDIATRICS ◽  
1969 ◽  
Vol 44 (3) ◽  
pp. 452-452
Author(s):  
Deryle T. Whipple
Keyword(s):  
Young Child ◽  
Physical Examination ◽  
Infectious Mononucleosis ◽  
Recent Article ◽  
Complete Physical Examination ◽  
Limited Coverage

In a recent article in Pediatrics (43:290, 1969) , Dr. Cone reviewed the approach to a child with fever. The list of patients with fever of undetermined origin will shrink markedly in the presence of a complete physical examination (especially the ears), a CBC, and urinalysis performed properly. I am surprised Dr. Cone omits infectious mononucleosis from his admittedly limited coverage of this subject. In the young child the Mono test or Heterophile may remain consistently normal.

Recurrent Abdominal Pain in Childhood

1982 ◽  
Vol 4 (1) ◽  
pp. 29-34
Author(s):  
Giulio J. Barbero
Keyword(s):  
Abdominal Pain ◽  
Preschool Children ◽  
Early Adolescence ◽  
Recurrent Abdominal Pain ◽  
Practical Approach ◽  
Gastrointestinal Function ◽  
Organic Disease ◽  
Common Complaint ◽  
Aged Child ◽  
And Function

Recurrent abdominal pain (RAP) in childhood is a common complaint that may be difficult to diagnose and manage. Apley has reported that 10% of children have three or more episodes severe enough to impair activity and function over at least a three-month period. RAP appears less often in preschool children and, when present at earlier ages, it usually occurs in brief episodes rather than the more frequent and intense pattern that is characteristic of the school-aged child. RAP is more frequent in girls and is particularly prominent as a symptom in early adolescence. Occasional abdominal pain is a universal symptom in childhood and its significance is often difficult to assess. A practical approach is to determine the frequency, severity, and limitations produced by the pain before further exploration of its cause. DIAGNOSIS Recurrent abdominal pain in childhood can be divided into disturbances of gastrointestinal functions and a variety of pathologic disease or organic categories. A combination of the disturbance of function and other organic disease can also be present as the basis for the pain. Fewer than 10% to 15% of referred children reported in various studies have been found to have pain of organic origin. It is important to recognize that many patients and their parents are fearful of the pain as a symptom and are not easily able to incorporate a concept of disorder of a gastrointestinal function at the onset.

Abdominal Pain in Girls at Puberty

PEDIATRICS ◽  
1967 ◽  
Vol 40 (5) ◽  
pp. 924-925
Author(s):  
MORRIS A. WESSEL
Keyword(s):  
Abdominal Pain ◽  
Hormone Level ◽  
Recurrent Abdominal Pain ◽  
Diagnosis And Treatment ◽  
Physical Findings

Morris Green's article "Diagnosis and Treatment: Psychogenic, Recurrent, Abdominal Pain" in the July 1967 issue of Pediatrics calls attention to a presenting complaint well-known to pediatric practitioners. Girls in the early months of puberty often come to their physicians with a complaint of recurrent abdominal pain of a somewhat cyclical nature. Physical findings are variable, although there is often some tenderness in one of the lower abdominal quadrants. The general heightened sensitivity to any bodily discomfort which accompanies the pubertal increase in hormone level causes pubescent girls to be quite aware of and frightned by this pain.

scholarly journals Diagnosis and Treatment of Multiseptate Gallbladder with Recurrent Abdominal Pain

2011 ◽  
Vol 2011 ◽  
pp. 1-2 ◽  
Author(s):  
Turgut Karaca ◽  
Omer Yoldas ◽  
Bulent Caglar Bilgin ◽  
Selma Bilgin ◽  
Ender Evcik ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Laparoscopic Cholecystectomy ◽  
Female Patient ◽  
Congenital Malformation ◽  
Recurrent Abdominal Pain ◽  
Diagnosis And Treatment ◽  
Multiseptate Gallbladder ◽  
Gastrointestinal Complaints ◽  
Upper Abdominal

Laparoscopic cholecystectomy is usually performed for gallstones or polyp of the gallbladder. Multiseptate gallbladder is a rare congenital malformation. Although several asymptomatic cases have been described, patient usually present with right upper abdominal pain. We present a 29-year-old female patient with multiseptate gallbladder, cholecystectomy was performed, and her abdominal pain and gastrointestinal complaints have resolved.

Recurrent abdominal pain

2011 ◽  
Author(s):  
R. Mark Beattie ◽  
Anil Dhawan ◽  
John W.L. Puntis
Keyword(s):  
General Practice ◽  
Abdominal Pain ◽  
Treatment Strategies ◽  
Recurrent Abdominal Pain ◽  
Family Factors ◽  
Therapeutic Options ◽  
Clinical Approach ◽  
Organic Disease ◽  
Disease Treatment ◽  
School Aged Children

Introduction 256Classification 257Personality type and family factors 259Common stresses in children with recurrent abdominal pain 259Therapeutic options 260Outcome 261Recommended clinical approach 261• Recurrent abdominal pain is common in school-aged children and is a frequent presenting complaint in general practice and general paediatric and paediatric gastroenterology clinics. Patients often have vague symptomatology and investigation usually results in a low yield of organic disease. Treatment strategies are varied and often subjective with very little evidence upon which to base them....

Recurrent abdominal pain

2018 ◽  
Author(s):  
Mark Tighe ◽  
Mark Beattie
Keyword(s):  
General Practice ◽  
Abdominal Pain ◽  
Treatment Strategies ◽  
Recurrent Abdominal Pain ◽  
Clinical Approach ◽  
Organic Disease ◽  
Limited Evidence ◽  
Disease Treatment ◽  
School Aged Children ◽  
Complex Cases

Recurrent abdominal pain occurs in 10–15% of school-aged children and is a frequent presenting complaint in general practice and general paediatric and paediatric gastroenterology clinics. Patients often have vague symptoms and investigation usually results in a low yield of organic disease. Treatment strategies are varied and often subjective with limited evidence upon which to base them. This chapter includes a general overview, classification, discussion of the complex and multifactorial aetiology, therapeutic approach, and outcome. It discusses a recommended clinical approach for the management of complex cases.

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