Abdominal pain (children)

Abdominal pain is a common presentation in children. While the symptoms may result from serious abdominal pathology, in a large proportion of cases, an identifiable organic cause is not found. When a cause is identified, the cause is often age dependent.

• Lower abdominal pain (e.g., appendicitis, constipation, gynecologic issues)

• Flank pain (e.g., pyelonephritis, kidney stones)

• Epigastric pain (e.g., gastroesophageal reflux)

• Generalized/diffuse pain (e.g., functional, infantile colic, malabsorption)

Given a pediatric patient with abdominal pain, the candidate will diagnose the cause, severity, and complications and initiate an appropriate management plan.

• list and interpret critical findings, including those derived from

  • a detailed history, including characteristics of the pain;

  • an appropriate physical examination, including

    • general abdominal examination

    • special manoeuvres if relevant (e.g., rebound tenderness, shifting dullness)

    • rectal, genitourinary, and/or other system examinations if relevant

  • the identification of causes of abdominal pain requiring a surgical procedure;

  • the differentiation of possible psychological causes or psychosocial circumstances in case of chronic abdominal pain;

• list and interpret critical investigations, including

  • laboratory investigations;

  • diagnostic imaging;

• construct an effective initial management plan, including

  • determining whether emergency intervention is required;

  • determining appropriate medical, surgical, and nonpharmacologic management for common causes of abdominal pain based on age;

  • determining whether specialized care and/or further investigations are required (e.g., endoscopy);

  • recognizing possible underlying psychosocial issues leading to abdominal pain.