Recurrent abdominal pain ------------------------ pediatrics ------------------------------www.medkaau.

com\vb

Causes of recurrent abdominal pain

3 or more attacks of sever pain within 3 months, severe enough to affect activities

Nonorganic\Functional
1. IBS 2. non-ulcer syndrome 3.abdominal migraine
- central periumblical abdominal pain, with family Hx of recurrent abdominal pain, migraine or IBS +
healthy child.

Organic :
GIT:
1. Chronic constipation 2. Lactose intolerance
3. Infection e.g. giradiasis 4. Crohn’s disease
5. Peptic ulcer 6. Meckel’s diverticulum
7. Intussusception 8. Chronic appendicitis
9. Internal, inguinal abdominal wall hernia

Gall bladder & pancrease

1. cholelithiasis 2. choledochal cyst
3. recurrent pancreatitis

GUT
1. UTI 2. Hydronephrosis
3. Urolithiasis

Miscellaneous
1. Familial Mediterranean fever: self-limited Paroxysmal episodes of fever,
severe abddpminal pain and tenderness, it is a hereditary disease i.e. MEFV
gene.
2. Sickle cell crisis 3. Chronic form of HSP
4. Abdominal Migraine\ Epilepsy 5. DKA 6. Gilbert Syndrome

Dr.Designer -----------------------------------------------------------------------------------------wwww.medkaau.com\vb
Recurrent abdominal pain ------------------------ pediatrics ------------------------------www.medkaau.com\vb

Investigations of acute abdominal pain : “ there are complete work-up, but if you are
great doctor you have to choose according to your suspicion ! ”
1. CBC :
Leukocytosis indicate necrosis, bacterial infection, abscess .
looking for anemia, low MCV – indicates blood loss.
thrombocytosis – indicate inflammation

2. ESR & CRP : indicate inflammation .

3. Creatinine : to asses the renal function .
4. Urea & Electrolytes : in case of dehydration .
5. LFT & Bilirubin : indicate liver or biliary disease .
6. Serum Amylase/lipase : increase in pancreatitis .
7. Random blood sugar : increase in DKA
8. Blood typing & cross matching
9. Coagulation test : PT, PTT.
10. Urine analysis : indicate UTI & Hematouria .
11. urine pregnancy test : in case of ectopic pregnancy .
12. Blood , throat , stool , cervix & urine culture : if infection is suspected .
13. Autoantibody screen : in case of crohns disease ,U.C. ,Biliary cirrhosis or chronic
active hepatitis.
14. Peripheral smear : for HUS, Sickle cell.
15. plain abdominal x-ray : bowel obstruction , free intraperitoneal air, appendiceal
fecalith & kidney stone.
16. KUB : if urinary tract disease is suspected.
17. IVP : for stone or ectopic kidney.
18. CT scan : to rule out abscess, appendicitis, crohn, pancreatitis, Gallstone &
kidney stone .
19. U/S : Gallstone, appendicitis, pancreatitis, intussusceptions & kidney stone.
20. Upper Endoscopy : for PU or esophagitis.
21. Barium enema : for intussusception or malrotation.
22. ABG : for metabolic acidosis or acid –base imbalance .
23. Screening test : for hepatitis .
24. urea breath test : for helicobacter pylori .
25. Breath hydrogen test : for lactose intolerance

Dr.Designer -----------------------------------------------------------------------------------------wwww.medkaau.com\vb