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Differential diagnosis of abdominal pain in children

SOVREMENNAYA PEDIATRIYA.2019.1(97):75-81; doi 10.15574/SP.2019.97.75

Dudnyk V., Mantak H., Andrikevych I., Zvenigorodska G., Odnorohova H.
National Pirogov Memorial Medical University, Vinnytsia, Ukraine

Abdominal pain is one of the most common complaints among those who apply to a doctor. It is one of the leading causes of emergency hospitalization of children. The aim of the work was to summarize the current scientific data about abdominal pain in children for better differential diagnosis and confirmation of the diagnosis. The review was conducted in the PubMed system, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, for the period from 2004 to 2018. Diffuse abdominal pain is most common for young children, it is colic-like and has acute onset. Usually it is neonatal colic when there is no fever, normal number of defecations, absence of vomiting, standard gaining of bodyweight. Abdominal pain in right upper quadrant is due to pain in the lower part of the right lung, pleura, diaphragm, liver and gallbladder, duodenum, kidney and upper urinary tract, pancreas, and appendix at its high position. Pain in the upper quadrant of the abdomen on the left can be caused by disease of the heart, pericardium, the lower part of the left lung and pleura, diaphragm, stomach, pancreas, spleen, the left kidney and the upper part of the urinary tract. Pain in the lower quadrant of the abdomen on the right appears in case of disease of the colon, appendix, right kidney and ureter, uterus, bladder. Pain in the lower quadrant of the abdomen on the left can be due to disease of left kidney and ureter, appendages of the uterus, large intestine, bladder. Abdominal pain in children varies. Differential diagnosis of abdominal pain in each case needs very careful examination of the patient, attention to the medical history and to results of tests, high quality and experience of the doctor.

Key words: children, abdominal pain, classification, differential diagnosis.

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Article received: Oct 21, 2018. Accepted for publication: Feb 12, 2019.