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Ped Abdo
| Question | Answer |
|---|---|
| Is pediatric abdo pain common? | Yes its 5% of of ED ped presentations. Only1-7% require surgical interventions. >15% leave without definitive diagnosis. |
| What nerve fibers are abdo pain transmitted through? | Either somatic of visceral afferent fibers. |
| Define visceral pain. | Pain that originates from the blood vessels and the organs. These areas are not well innervated with sensory nerves therefor the pain is most of the time dull or vague and my be hard to pinpoint. |
| Define somatic pain. | Somatic pain is often described as musculoskeletal pain and may be more intense. It is also easier to locate than visceral pain. |
| Where does referred abdo pain often occur? | Where visceral and somatic fibers converge in the spinal cord. For instance, diaphragmatic irritation leads to pain leads to pain in the shoulder due to the convergence of S and V pathways at C4. Somatic pain from pneumonia leads to pain in T10-T11. |
| What are 5 important questions in the non-trauma abdo pain assessment? | Age. First episode or recurrence? Associated symptoms? Relevant pre-existing conditions? Characteristics of the pain? |
| What is the weight formula for children under the age of 1 yr? | 4+ (age in months/2) |
| What is the weight for children over the age of 1yr? | (AgeX2)+10. |
| What may be signs of pain besides crying? | Inability to be consoled. Irritability. Sleeplessness. Poor feeding. Clenching or fisted hands and retraction of legs. |
| What are the most common causes of abdo pain in the neonate and infant? | Colic and gastroenteritis. |
| How old is a neonate? | Up to 28 days. |
| How old is an infant? | 1-12 months. |
| How old is a toddler? | 1-3 years. |
| How old is a preschooler? | 3-5 years. |
| How old is a school aged child? | 6-12 years. |
| How old is an adolescent? | 13-18 years. |
| What serious medical conditions may be the cause of pediatric abdo pain? | Diabetic ketoacidos. Toxic - ingestion. Sepsis. Haemolytic uraemic syndrome. UTI. |
| What serious conditions that require surgery may be causing pediatric abdo pain? | Testicular torsion. Appendicitis. Peritonitis. Necrotsing entrocolitis. Volvulus. Intussusception. Incarcerated hernia. Hirschsprung disease. |
| What are the most common causes of abdo pain in the preschooler 3-5yrs. | Constipation. Acute gastroenteritis. UTI. Appendicitis. Mesenteric adentitis and other viral illnesses. Pneumonia. Trauma related. |
| What are the most common causes of abdo pain in the school aged 6-12yr? | Constipation. Acute gastroenteritis. |
| What are common adolescent (13-18yr) abdo pain causes? | UTI. Pyelonepheritis. Appendicitis. Viral illnesses. Inflammatory bowel/obstruction. IBS. Trauma/NAI - abuse. Gynaecological causes. |
| What gynaecological conditions may present as abdo pain in the adolescent? | STI. Pregnancy related pain. Dysnmenorrhoea - painful menstruation. Ovulation pain. Ovarian cysts. PID - Pelvic inflammatory disease. Endometriosis. Neoplasm - tumor. Ectopic pregnancy. |
| What are common associated symptoms of abdo pain? | Anorexia Nausea Vomiting Micturition (urination)- Increased frequency, dysuria/anuria, haematuria, incontinence. Bowel function - Stool cosistency/colour? Timing? Diarrhoea? Presense of blood/mucus? Pallor/Flushed/Rash. Lethargy,sleep prob,UTI,Mens |
| What questions can you ask regarding co-morbidities regarding abdo pain. | What is the child's surgical and medical Hx? Appendix? Medications and what had they had for pain relief? Hernia? Diabetes? Food intolerance, irritable bowel, allergies? NAI? Psychosocial Hx? |
| Eks op bl 6 |
Created by:
boermedic
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