Acute abdominal pain in children: an analysis of admissions over a three year period.
A quality audit was performed of the case records of 1313 children admitted with acute abdominal pain over a three year period under the care of paediatric surgeons at the Princess Margaret Hospital for Children, Perth. Fifty-four per cent (n = 714) of the patients were discharged without surgical intervention; in this group the most frequent (70%, n = 503) diagnosis was non-specific abdominal pain (NSAP). Of those children having surgery, 74% (n = 443) had appendicitis proven on histopathology; the remaining appendices (n = 134) were reported as normal and no other surgical cause for the patients symptoms were identified. Only 3.7% (n = 22) of children having surgery had another surgical cause for their pain. Of this group, 11 had adnexal pathology, eight had complications of a Meckel's diverticulum and three had torsion of the omentum. There were no deaths in this series, and 39 patients (3%) had wound infections. Based on these results, only 35% of children referred to a surgeon with abdominal pain will actually require surgical intervention, although as a consequence of concern over clinical status an additional 10% will have a laparotomy with normal findings.
Department of Paediatric Surgery, Princess Margaret Hospital for Children, Perth, Australia.
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Holland
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Gollow
D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D001062:Appendectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008485:Medical Audit; D013997:Time Factors; D014904:Western Australia / Q000453:epidemiology