Acute abdominal pain is common in the pediatric population. Abdominal pain is usually associated with fever, vomiting of bile, bloody diarrhea, rigidity and tenderness in the abdomen. The etiology and differential diagnosis depend on the age of the child. For instance, Infants and toddlers will have congenital anomalies, school-aged children may have gastroenteritis and other infectious causes. Appendicitis is the most common cause of the onset of acute abdominal pain in children.
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Differential Diagnosis of Pediatric Acute Abdominal Pain

There are a variety of conditions that may cause acute abdominal pain in a child. The age of the child determines the differential diagnosis.

Differential diagnosis of acute abdominal pain by predominant age:

The causes of abdominal pain in a child are divided into surgical causes, medical causes, and non-specific abdominal pain.

Causes of abdominal pain Details
Surgical causes
Acute appendicitis Classically begins as peri-umbilical pain that then migrates to the right iliac fossa, seen in school-aged children and adolescents.
Intussusception  Most common between 3 and 18 months of age. Intermittent attacks of abdominal pain with screaming, pallor, and drawing of legs.
Volvulus Occurs secondary to malrotation in an infant who classically presents with bilious vomiting due to small bowel obstruction.
Strangulated inguinal hernia Tender groin lump present.
Peritonitis Generalized tenderness with signs of peritonism, including guarding and rigidity. The patient may lie still to avoid provocation of pain.
Pancreatitis Epigastric or left upper quadrant pain that radiates to the back.
Testicular torsion Seen in adolescents, Tender, swollen testes.
Trauma Mostly found in school-aged children, history or signs of trauma present.
Medical Causes
Gastroenteritis Triad of fever, diarrhea and abdominal pain.
Hepatitis Pain in the right upper quadrant.
Inflammatory bowel disease May be associated with episodic abdominal pain over a long time period.
Constipation  Common in infants and school-aged children.
Lower lobe pneumonia Referred pain to the upper abdomen accompanied by respiratory symptoms.
Urinary tract infection Presence of urinary symptoms such as dysuria.
Diabetic ketoacidosis Associated with hyperglycemic symptoms of polyuria, polydipsia and polyphagia, and dehydration.

Other causes of pediatric acute abdominal pain include:

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