Decision making for management of acute abdominal pain in children

Yoo, Jong Sig; Sung, Nak Jin; Park, Ki Heum

Abstract

BACKGROUND: Acute abdominal pain in children is one of the most common problems encountered in our daily practice. The children often are not able to tell us their exact complain symptoms and differential diagnosis of acute abdominal pain is difficult in its first encounter. When family physicians encounter patients with acute abdominal pain in the ambulatory care settings, they must make an appropriate decision for proper management such as admission, referral, discharge and follow-up without firm diagnosis. If it is possible to predict the course or prognosis of acute abdominal pain by clinical data concerning patient, it will be helpful to make a decision for the management of acute abdominal pain. So we tested for hypothesis that patients with acute intermittent abdominal pain and normal simple abdomen X-ray finding is not serious and shows favorable outcome. METHOD: 82 patients with acute abdominal pain were assessed from Oct. in 1996 to Sep. in 1997 at the emergency department of Kyungju Hospital, Dongkuk University. 69 patients among 82 showed normal simple abdomen X-ray findings. 67 patients were discharged and 2 patients were admitted. 64 patients were contacted by phone call after 1 week and reported their outcome of the previous abdominal pain.
RESULTS
Among 64 subjects 36 patients were male and 28 patients female. 57 patients complained of intermittent abdominal pain and 7 patients complained continous abdominal pain. Positive predictive value of intermittent abdominal pain and normal simple abdominal x-ray was 98%. Outcome of patients with intermittent abdominal paln was more favorable than that of continuous pain.
CONCLUSIONS
Acute intermittent abdominal pain and normal simple abdomen x-ray findings in children shows favorable outcome and can be managedim ambulatory care settings.