Abdo Pain/Vomiting Flashcards Preview

Paeds - GIT > Abdo Pain/Vomiting > Flashcards

Flashcards in Abdo Pain/Vomiting Deck (13):
1

What is functional abdo pain? How often does it occur?

- Non-specific pain, no organic cause
- 10-15% cases

2

What are some DDx for abdo pain in: neonates

Congenital:
- Hirschsprung’s 
- Meckel's diverticulum

Surgical: 
- Incarcerated hernia 
- Intussusception 
- Pyloric stenosis
- Volvulus

Other:
- Irritable/ unsettled (colic) 
- Colic
- GORD
- UTI

3

What are some DDx for abdo pain in: infants/pre-school

GIT:
1. Appendicitis 
2. Gastroenteritis 
3. Intussusception 
4. Volvulus 
5. Constipation 

Other:
6. Pneumonia 
7. UTI 

4

What are some DDx for abdo pain in: school-aged

GIT:
1. Appendicitis 
2. Gastroenteritis 
3. Mesenteric adenitis 
4. Constipation 

Repro:
5. Testicular torsion 
6. Ovarian pathology 
I
nfection:
7. Pneumonia 
8. UTI  
9. Viral illness 

Other:
10. DKA 
11. HSP 
12. Migraine 

5

What are some DDx for abdo pain in: adolescents

GIT:
1. Appendicitis 
2. Ectopic pregnancy 
3. Cholecystitis/ cholelithiasis 
4. Gastroenteritis 
5. IBD 
6. Pancreatitis 

Repro:
7. Ovarian cyst – torsion, rupture 
8. PID 
9. Testicular torsion

Infection:
10. UTI 
11. Viral illness  

Other:
12. DKA  
13. Renal calculi 

6

What does episodic abdo pain point towards?

intussusception, mesenteric adenitis, gastroenteritis, constipation

7

What does bilious vomiting imply? What should you do next with this info?

• Bilious vomiting implies volvulus or bowel obstruction and warrants surgical review. 

8

Signs of peritonism

○ Won't want to move
○ Can't walk/fail hop test
○ Abdominal tenderness with percussion
○ Internal rotation of the right hip can irritate an inflamed appendix.

9

What are some Ix you could do to investigate abdo pain?

• urine MCS
• blood sugar for DKA
• electrolytes +/- LFTs
• Lipase (pancreatitis)
• urine pregnancy test/ quantitative beta hCG
• Coeliac serology and total IgA - consider for chronic abdo pain
• Imaging
○ AXR if obstruction suspected. Not helpful in diagnosing constipation.
○ CXR if pneumonia suspected
○ Ultrasound

10

DDx for neonatal bilious vomiting

• Malrotation with volvulus 
• Duodenal atresia 
• Intussusception (late presentation) 
• Strangulated inguinal hernia (late presentation) 
• Hirschprung's disease (late presentation) 
• Meconium ileus 

11

DDx for neonatal non-bilious vomiting

• Gastroenteritis 
• GOR/GORD 
• Pyloric stenosis 
• Infection (UTI, meningitis, pneumonia, OM, septic arthritis, sepsis) 

12

DDx for acute vomiting in children

• Gastroenteritis  
• Appendicitis (Uncommon in <5yo) 
• DKA 
• Infection (UTI, meningitis, pneumonia, OM, septic arthritis, sepsis) 
• Causes of raised ICP (hydrocephalus, haematoma, tumour, meningitis) 
• Migraine  
• Intussusception 
Malrotation with volvulus (90% Px in first year) 

13

DDx for chronic vomiting in children

• CMPI 
• GOR/GORD