title: Beyond appendicitis:  evaluation and surgical treatment of pediatric acute abdominal pain.
abstract: OBJECTIVE
  Evaluation of the child with acute abdominal pain is challenging because of the wide range of potential diagnoses. Presenting symptoms, clinical examination, and laboratory findings can guide selection of diagnostic imaging.
  
  
  RESULTS
  Intussusception and intestinal malrotation are potentially serious causes of intestinal obstruction, which are best evaluated by ultrasound and upper gastrointestinal series, respectively. Ultrasound has diagnostic importance in the evaluation of multiple diseases, including appendicitis, by potentially decreasing the need for inpatient observation, cholecystitis and complications of gall stones such as pancreatitis, and ovarian diseases. Pelvic inflammatory disease should be considered in evaluation of a teenage girl with lower abdominal pain. Less common causes of acute abdominal pain include ingested foreign bodies, infected congenital anomalies, and perforated peptic ulcer disease.
  
  
  CONCLUSIONS
  Presenting symptoms and physical examination findings can narrow the number of potential diagnoses in pediatric acute abdominal pain and thereby guide diagnostic imaging selection. Abdominal/pelvic ultrasound, rather than computed tomography scan, is the preferred modality for initial evaluation of many potential causes of pediatric abdominal pain.
authors.affiliation: Division of Pediatric Surgery, Washington University School of Medicine, St Louis, Missouri, USA. saitoj@wudosis.wustl.edu
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Saito
mesh_terms: D000006:Abdomen, Acute / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D001064:Appendicitis / Q000175:diagnosis / Q000601:surgery; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D000292:Pelvic Inflammatory Disease / Q000150:complications / Q000175:diagnosis; D014463:Ultrasonography