Acute abdomen in children due to extra‐abdominal causes

Tsalkidis, Aggelos; Gardikis, Stefanos; Cassimos, Dimitrios; Kambouri, Katerina; Tsalkidou, Evanthia; Deftereos, Savas; Chatzimichael, Athanassios

doi:10.1111/j.1442-200x.2008.02578.x

Cited by 26 publications

(17 citation statements)

References 17 publications

(20 reference statements)

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“…During the two years of work of a single pediatric radiologist, it was noted that abnormal findings within the lung bases were found in 22 patients, in whom the referral diagnosis did not in any way suggest the existence of a pulmonary pathology. Most of the referral diagnoses in this group of children concerned abdominal pain, and pneumonia is, in several studies, referred to as the most common extra-abdominal cause of the abdominal pain (2,3,21). Our study revealed 0.95% prevalence of pneumonia in outpatients with abdominal pain, which is lower than it is reported in the literature -1.6% to 2.2% (2,(22)(23)(24).…”

Section: Fig 6 a 13-year-old Boy Came As An Outpatient To The Pediatcontrasting

confidence: 49%

“…The causes of acute abdominal pain in children which stand out are: constipation, mesenteric lymphadenitis, acute appendicitis, gastroenteritis and ileocolic intussusception (1). However, the causes of acute abdominal pain in children can also be of extra-abdominal origin, of which pneumonia is the most prominent one (2,3). Pneumonia can also be found as an "accidental" finding in other conditions that demand an abdominal US evaluation.…”

Section: Introductionmentioning

confidence: 99%

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Abdominal ultrasound in children - are we careful enough when it comes to lung bases?

et al. 2016

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Objective -To investigate the frequency of positive findings within the lung bases during abdominal ultrasound (US) examinations in children with referral diagnosis not suggesting pulmonary disease. Materials and methods -A retrospective study included all children with abdominal US performed within 2 years by a single pediatric radiologist in the regional children's hospital. Of all examined children, 22 (mean 7.4 y, SD=4.2 y) had pathological findings detected within the lung bases, without referral diagnosis suggesting a pulmonary pathology. Each abdominal US included a trans-abdominal (trans-hepatic and trans-splenic) approach to both lung bases. Results -While performing abdominal US a detected pulmonary pathology included: 19 pneumonias and 3 pleuropneumonias, with the most common referral diagnosis being abdominal pain (15 children), followed by nausea and vomitting (3 children), febrile convulsiones (2 children), exacerbation of juvenile arthritis (1), and a routine follow-up a day after hydrostatic reduction of ileocolic intussusception (1). In outpatients with referral diagnosis of abdominal pain, 0.95% had positive lung base US findings. Conclusion -Each radiologist should be aware of the potential pathological finding within the lung bases when performing abdominal ultrasound in children. Its detection might have a serious impact on the patient's treatment.

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Section: Fig 6 a 13-year-old Boy Came As An Outpatient To The Pediatcontrasting

confidence: 49%

Section: Introductionmentioning

confidence: 99%

Abdominal ultrasound in children - are we careful enough when it comes to lung bases?

et al. 2016

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“…Diagnosing occult pneumonia may be challenging. Symptoms and signs such as abdominal pain and meningeal irritation can falsely lead to the diagnosis of appendicitis or meningitis, when they are in fact caused by referred pain from consolidation of the lower and upper lobes, respectively 5 6. In a retrospective study in febrile children under 10 years of age who presented to the emergency department with fever without respiratory symptoms, the incidence of occult pneumonia was 5.3% 7.…”

Section: Discussionmentioning

confidence: 99%

Occult pneumonia in a child

Ploegstra

Onnes²,

Vries³

et al. 2012

Case Reports

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We describe the case of a 10-year-old boy who presented with high fever, vomiting and diarrhoea. There were no respiratory symptoms and auscultation and percussion of the lungs were normal. The combination of the clinical picture with a high C reactive protein value prompted us to perform a diagnostic work-up. A chest radiograph showed abscess formation in a lobar pneumonia in the right upper lobe and intravenous antibiotic therapy was started. The patient recovered and treatment was continued with oral antibiotics. Radiologically confirmed pneumonia in a febrile patient without respiratory symptoms is described as occult pneumonia. An increased number of leucocytes and/or an increased C reactive protein value can predict occult pneumonia in febrile children. This case highlights the diagnostic challenge of pneumonia in febrile children without respiratory symptoms and reminds clinicians to consider occult pneumonia in the differential diagnosis of fever without source.

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“…1 Intra-abdominal causes include gastrointestinal, genitourinary, gynecologic and vascular distress, whereas extra-abdominal causes include cardiac, pulmonary, abdominal wall, toxic, metabolic and neurologic disorders. 2 The children with presenting symptoms of acute abdomen having extra-abdominal etiology account for 17.1% of cases. 3 In the present case, the patient was admitted for abdominal pain, but without any significant positive term findings in the abdomen.…”

Section: Discussionmentioning

confidence: 99%

An unusual presentation of thoracic para-aortic hematoma due to blunt trauma

et al. 2010

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An 11-yr-old boy was admitted to the hospital with gradually aggravating acute abdominal pain along with nausea, vomiting and constipation for 5 days. The pain started after blunt trauma on the superior abdomen. He had normal laboratory tests and abdominal examination, but his chest radiograph showed infiltration in the right lung and an abnormal mass on the left diaphragm. Further investigation like computed tomography (CT) and magnetic resonance MR angiography, revealed an abnormal para-aortic mass located a mass located para-aortic above posterior to the left diaphragm with a well-defined margin. The abnormal mass was finally confirmed to be a hematoma with exploratory thoracotomy. The rarity of this kind of presentation is discussed for making an early and correct diagnosis.

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Acute abdomen in children due to extra‐abdominal causes

Abstract: Both abdominal and extra-abdominal causes should be considered by a pediatrician who is confronted with a child with acute abdominal pain.

Cited by 26 publications

References 17 publications

Abdominal ultrasound in children - are we careful enough when it comes to lung bases?

Abdominal ultrasound in children - are we careful enough when it comes to lung bases?

Occult pneumonia in a child

An unusual presentation of thoracic para-aortic hematoma due to blunt trauma

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