Approach to Child with Abdominal Pain PDF

Approach to Child with Abdominal pain Supervised by : DR Nagham Elbeblawy  Objective : 01. 02. 03. 04. Types and Clinical picture Assessment Lines of classification and causes of and management o...

Approach to Child with Abdominal pain Supervised by : DR Nagham Elbeblawy  Objective : 01. 02. 03. 04. Types and Clinical picture Assessment Lines of classification and causes of and management of abdominal acute and investigations of a child with pain chronic for recurrent recurrent abdominal pain abdominal pain abdominal pain Types and classification of abdominal pain Abdullah Alzubaidi 1711071  - ↳ - Diffuse pain L 3 zed pain stomach · > - epigastric. & - + retrosternal - Pancreasa b invert - 3 - - * - - - allbladder-right · scapula  Sudden perforation , infarction > - = Acute (discrete , Abrupt according ↳ Gradual To (7 12y) - = Infection , inflammation. - Spain for at least 3months S S - - - - - = - = - Abdominal pain Conset - = Aute chronic least 3months --- At sudden gradual > Infection - Discrete Abrupt , > - Inflammation > - infarction , perforation  D ① - - 0 - - - in pedia -important - ⑳ ⑦ -⑳ --⑩ Clinical picture and causes of acute and chronic abdominal pain Faisal Alzahrani 1811081  gastric pain * r = D > - wond Key ④ ↓ Assessment and investi ations o recurrent abdominal pain Lama Alghamdi 2220264 History Site  History RA # T abdominal pain ses Sudden or gradual, prior Onset episodes, associated with Extra Cough, dyspnea , dysuria , meals, history of injury intestinal urinart frequency, flank pain symptoms , hematuria Nature Sharp vs dull , colicky or constant , burning Worsening or improving, change Course in nature or location, aggrevating or relieving factors Associated symptoms Fever , vomiting, diarrhea, abdominal distention Examination Hydration, degree of General discomfort and body Breath sounds, wheezing, flank position Surrounded tenderness, tenderness of structures abdominal wall structures and ribs Abdominal Tenderness , distention , bowel sound , rigidity , guarding and masses perianal lesion , tenderness and Rectal feacl impaction Genitalia testicular torsion , hernia and pelvic inflammatory disease Laboratory CBC,CRP,ESR ( For evidence of infection or inflammation) - AST,ALT,GGT,BILIRUBIN (for biliary or liver disease) AMYLASE,LIPASE (For pancreatitis) - URINALYSIS ( for UTI , Bleading due to stone or trauma , Obstruction ) PREGNANCY TEST ( To rule out Ectopic pregnancy) SEROLOGICAL MARKERS INCLUDES “① IgA antiendomysil antibody , IgA tissue transglutaminase antibody “ ( To rule out celiac disease) LACTOSE TOLERANCE TEST (to Rule out lactose intolerance ) Radiology Plain flat and upper right abdominal film(For bawel obstruction , free intraperitoneal air ,kidney stones) CT SCAN (for Intra-abdominal or pelvic abscess , appendicitis , Crohn's disease , pancreatitis , gall stones) BARIUM ENEMA (for intussusception , Malrotation ) ULTRASOUND (For gall stones , appendicitis , pancreatitis , kidney stones , intussusception) ENDOSCOPY UPPER ENDOSCOPY (For suspected peptic ulcer or esophagitis) Lines o mana ement o child with recurrent abdominal pain Razan Alnofaie 1920280 management of recurrent abdominal pain For all types of RAP in children, the primary goals of management are improving quality of life, reducing parent and child concern about the seriousness of the condition, and reducing disability associated with pain rather than complete resolution of pain. reassure the parents The child must be assisted in returning to normal activites and regular school attendance immediately. The purpose is to break the cycle of pain and disability by decreasing anxiety. Fiber supplements & probiotcs may help to manage symptoms of IBS. Cognitive behavioral therapy and mental health ( for functional abdominal pain ) may have a role with persistence of significant anxiety or social dysfunction.  management of recurrent abdominal pain Management of acute and chronic abdominal pain depends on the underlying cause. Irritable bowel syndrome ( advise them to eating meals that are low in fat and increase intake of fluids,fibers) Celiac disease ( avoid gluten in diet “ gluten free diet” ) Infection ( Antibiotics ) Lactose intolerance ( lactose free diet ) H.pylori ( 2 antibiotics like amoxicilin + Metronidazole + PPI ) Surgical ( for appendicitis, intussusception ) References Thank you very much!