Clinical outcomes of children with acute abdominal pain.
OBJECTIVE
To determine the prevalence, associated symptoms, and clinical outcomes of children presenting for a nonscheduled visit with acute abdominal pain.


METHODS
Historical cohort.


METHODS
Inner-city teaching hospital.


METHODS
A total of 1141 consecutive children, ages 2 to 12, presenting for a nonscheduled visit (clinic or emergency department) with a complaint of nontraumatic abdominal pain of < or = 3 days' duration were identified through a manual chart review.


METHODS
Collected data included: 1) demographic characteristics, 2) presenting signs and symptoms, 3) records from the hospital record for all children who returned within 10 days for follow-up, 4) test results, and 5) telephone follow-up. A clinical reviewer used the data to assign a final diagnosis to each patient.


RESULTS
The prevalence of children presenting with abdominal pain of < or = 3 days' duration was 5.1%. The most common associated symptoms were history of fever (64%), emesis (42.4%), decreased appetite (36.5%), cough (35.6%), headache (29.5%), and sore throat (27.0%). The six most prevalent final diagnoses, accounting for 84% of all final diagnoses, were upper respiratory infection and/or otitis (18.6%), pharyngitis (16.6%), viral syndrome (16.0%), abdominal pain of uncertain etiology (15.6%), gastroenteritis (10.9%), and acute febrile illness (7.8%). Approximately 1% of children required surgical intervention (10/12 for appendicitis). Approximately 7% of children returned within 10 days for reevaluation of their illness; on return, 11 had treatable medical diseases and 4 had diseases requiring surgical intervention.


CONCLUSIONS
An acute complaint of abdominal pain in children occurs in 5.1% of nonscheduled visits, is frequently accompanied by multiple complaints, and is usually attributed to a self-limited disease. Close follow-up will identify the 1% to 2% who proceed to have a more serious disease process. This epidemiologic data will aid clinic-based physicians who manage children with acute abdominal pain.
Scholer
S J
SJ
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, USA.
Pituch
K
K
Orr
D P
DP
Dittus
R S
RS
D015746:Abdominal Pain / Q000175:diagnosis / Q000453:epidemiology*; D000208:Acute Disease; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006753:Hospital Records / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015146:Midwestern United States / Q000453:epidemiology; D015995:Prevalence; D016896:Treatment Outcome