abdominal pain in children
Introduction
Introduction to abdominal pain in children Abdominal pain is one of the most common symptoms in childhood, and there are many causes of abdominal pain, almost involving various diseases. It can be either an intra-abdominal organ disease or an extra-abdominal lesion; it can be organic or functional; it can be a medical condition, a surgical condition, or even a medical condition, and the disease develops later. Mainly in the surgical situation. basic knowledge Sickness ratio: 0.5% Susceptible people: good for children Mode of infection: non-infectious Complications: electrolyte imbalance shock
Cause
Causes of abdominal pain in children
Intraperitoneal disease (30%):
Acute gastritis, gastroenteritis, stomach and duodenal ulcer, intestinal cramps, intestinal and biliary ascariasis, mesenteric lymphadenitis, acute necrotic enteritis, viral hepatitis, congenital choledochal cyst, various pancreatitis , various peritonitis, liver abscess, underarm abscess, urinary tract infection, bacterial dysentery and so on.
Abdominal disease (30%):
Respiratory diseases (upper respiratory tract infection, tonsillitis, lobar pneumonia, acute pleurisy), cardiovascular disease (acute heart failure, pericarditis, myocarditis), allergic diseases (allergic purpura, urticaria, asthma), Nervous system diseases (intercostal neuralgia, abdominal epilepsy), metabolic diseases (hypoglycemia, uremia, porphyria), infectious diseases (typhoid fever, epidemic cerebrospinal meningitis), and sepsis, herpes zoster, lead Poisoning and so on.
Childhood surgical disease (30%):
Acute appendicitis, gastric and duodenal ulcer with perforation, mechanical intestinal obstruction, intussusception, mesenteric artery embolization, acute volvulus, ileal diverticulitis complicated with perforation, obstruction, primary or secondary peritonitis, incarceration Inguinal hernia, urinary tract stones, hydronephrosis, liver rupture, spleen rupture, ovarian cyst torsion, testicular pedicle torsion, axillary abscess.
Prevention
Child abdominal pain prevention
Abdominal pain is a common condition in children. Almost every child has a stomachache experience, but the symptoms are light and heavy, and the duration is short and long. The abdominal pain is divided into two categories: medical disease abdominal pain and surgical disease abdominal pain.
Therefore, the causes of abdominal pain in children are various, and the methods of treatment vary from disease to disease. The condition should be observed for a certain period of time, and those with severe pain should seek medical treatment in time.
Complication
Childhood abdominal pain complications Complications electrolyte disorder shock
Complications such as water and electrolyte disturbances or shock can occur.
Symptom
Symptoms of abdominal pain in children Common symptoms intestinal fistula peptic ulcer intussusception radioactive pain persistent pain ileocecal valve insufficiency intestinal perforation intestinal dull pain emotional abdominal pain
Medical history:
1. Age: abdominal pain in children of different ages, the disease is also different, such as intestinal fistula is more common in infants under 3 months, often due to improper feeding or excessive swallowing air, intussusception, incarceration and intestinal infections are more common in children within two years of age, acute appendicitis, intestinal parasitic diseases are relatively rare, gastrointestinal infections, intestinal parasitic diseases, mesenteric lymphadenitis, biliary ascariasis, lobar pneumonia, abdominal epilepsy Allergic purpura, etc. are more common in older children.
2. The rapid onset of abdominal pain: rapid onset is often of great significance for differential diagnosis. Sudden onset or paroxysmal aggravation is often a surgical disease, such as acute appendicitis, strangulated intestinal obstruction, gastrointestinal perforation, intestine Nesting and incarceration of the inguinal hernia, slow onset and persistent pain are often medical diseases such as intestinal ascariasis, stomach and duodenal ulcer, enteritis and viral hepatitis, but pay attention to sometimes chronic abdominal pain and acute abdominal pain The cause can be the same, because the disease changes in its nature at different stages. For example, the ulcer pathogen is chronic abdominal pain, which is acute abdomen when combined with perforation. Therefore, the original chronic abdominal pain, such as abdominal pain, becomes persistent. Or sudden severe pain, should pay attention to the possibility of acute abdomen.
3. The nature of abdominal pain: abdominal pain can be paroxysmal pain, persistent pain or mild dull pain, paroxysmal pain or colic with obstructive disease, if the local tender or hot compress after abdominal pain reduction, often stomach, intestine , bile duct and other hollow organs of the sputum; persistent abdominal pain is more common in the gastrointestinal perforation; persistent dull pain, increased position, increased, refused to press, often abdominal organ inflammation, envelope stretch, tumor and peritoneal visceral layer Caused by irritation, dull pain is more common in peptic ulcer. Radioactive pain is a local lesion that spreads to other parts of the body through nerves or adjacent organs, such as lobar pneumonia, causing pain in the ipsilateral upper abdomen, abdominal pain accompanied by defecation or dysuria, possibly Fecal blockage or urinary tract infection, stones, in short, the pain characteristics of abdominal organic lesions are:
1 persistent dull pain, increased paroxysmal;
2 local tenderness is obvious;
3 have abdominal muscle tension;
4 bowel sounds abnormal.
4. The site of abdominal pain: the site of general abdominal pain is consistent with the site of the lesion.
5. Accompanying symptoms: attention should be paid to the relationship between abdominal pain and fever.
6. Past history: The child should be asked in detail whether there is any similar abdominal pain episode, history of fecal worms and skin purpura. It should be known whether there is any trauma before the onset, food hygiene and what kind of food to eat, all of which contribute to the diagnosis of the cause of abdominal pain. .
Examine
Examination of abdominal pain in children
1. Laboratory examination: regular examination of blood and urine, sometimes providing diagnostic value data such as hemoglobin and red blood cells gradually decline, be alert to the presence of internal bleeding, elevated total white blood cells often suggest inflammatory lesions, observation of fecal nature helps Diagnosis of intestinal infection and intussusception, there are more red blood cells or pus cells in the urine to suggest urinary tract infection, and if necessary, blood and urine pancreatic amylase should be detected.
2. X-ray examination: chest X-ray examination can show lung, pleural and heart disease changes, abdominal fluoroscopy and radiography, such as the discovery of free gas under the armpit, suggesting gastrointestinal perforation; trapezoidal liquid plane in the intestine, inflated in the intestine More, suggesting intestinal obstruction, if suspected and intussusception can be used as an air enema to assist diagnosis and reduction treatment, but suspected visceral perforation is prohibited, suspected urinary tract lesions can be taken abdominal plain film or for intravenous pyelography.
3. B-mode ultrasound: suspected cholelithiasis, liver abscess, submucosal abscess for abdominal B-mode ultrasound.
Diagnosis
Diagnosis and diagnosis of abdominal pain in children
diagnosis
Comprehensive analysis should be carried out in conjunction with medical history and physical examination, supplemented by laboratory tests or other examinations as necessary, to make early and correct diagnosis as soon as possible.
Differential diagnosis
It is mainly necessary to distinguish some diseases that cause abdominal pain, such as obstructive diseases, stomach, intestines, bile ducts and other hollow organs, gastrointestinal perforation, peptic ulcer and the like.
