J Korean Med Assoc.  2025 Feb;68(2):130-137. 10.5124/jkma.2025.68.2.130.

Pediatric abdominal pain: the need for a careful differential diagnosis according to age

• Yoo IH

• KMID: 2565516
• DOI: http://doi.org/10.5124/jkma.2025.68.2.130

Abstract

Background
Acute abdominal pain is a common yet clinically challenging symptom in pediatrics. Its potential causes range from self-limited conditions to life-threatening emergencies. Proper evaluation requires a thorough understanding of age-specific diseases, their clinical presentations, and appropriate diagnostic approaches. This review summarizes key considerations in the differential diagnosis of acute abdominal pain in children, emphasizing the importance of age-stratified management.
Current Concepts
The differential diagnosis of acute abdominal pain in children varies significantly with age, necessitating an age-specific approach. In neonates and infants, conditions such as necrotizing enterocolitis and volvulus require particular attention. In preschool-aged children, intussusception and appendicitis should be considered, while school-aged children and adolescents necessitate vigilance for appendicitis, inflammatory bowel disease, and gynecological issues. Evaluation begins with a thorough history taking and physical examination. When necessary, imaging studies (e.g., ultrasonography) and laboratory tests serve as valuable tools to identify inflammatory or infectious causes and differentiate between conditions requiring medical versus surgical management.
Discussion and Conclusion
Acute abdominal pain in children presents a complex diagnostic challenge due to its diverse etiologies, which vary in severity, diagnostic approaches, and prognosis. A critical feature is the marked variation in common and serious conditions depending on age. Clinicians must exercise careful judgment to ensure accurate diagnoses and remain vigilant in identifying children requiring urgent intervention.

Keyword

Pediatrics; Abdominal pain; Diagnosis; Age factors; 소아; 복부 통증; 진단; 연령