Abdominal pain in pediatric emergency room: One-year clinical experience

Objective: We aimed to analyse the clinical spectrum, physical examination, laboratory and imaging findings of the children, admitted to emergency room (ER) because of acute abdominal pain, in the last one year in our study.
Material and Method: Four hundred fifty one patients, admitted to ER were analysed in terms of demographic properties, etiology, physical examination, laboratory and imaging results and course of the disease from the records of the patients between the dates of january 2012- december 2012, retrospectively.
Results: 3700 of 94750 patients (3.9%) were taken to ER because of acute abdominal pain and 451 of them (12.2%) were observed in ER. The mean age was 7.01±1.62 years, and female/male ratio was 1.6. Vomiting was the most common symptom, accompanied to abdominal pain (45.4%). Off all the patients, 21.5% (n=97 patients) had history of recurrent abdominal pain and 29.9% of them (n=29 patients) diagnosed Familial Mediterranean Fever (FMF). Laboratory findings did not help us to determine the etiology in 74.9% of the patients (n=338 patients). Abdominal ultrasonography was performed on 26.82% (n=121 patients) of the patients and 46.7% of them (n=64 patients) were normal and 26.2% of them (n=36 patients) showed mesenteric lymphadenitis. Surgical causes was found in 11.6% of the patients (n=51 patients), the most common cause was acute appendicitis. Ultrasonographic findings helped the diagnosis in 71.4% of the patients requiring surgical intervention. The etiology wasn’t found in 12.6% (n=57 patients) of the children. Acute gastroenteritis was the most common cause among non-surgical reasons. 12.8% of the children (n=58 patients) were hospitalised.
Conclusion: The most common cause of acute abdominal pain was non-surgical causes in ER. USG findings supported the diagnosis in patients requiring surgical intervention.

Çocuk acilde karýn aðrýsý: Bir yýllýk klinik deneyim

Amaç: Çalýþmamýzda son bir yýlda akut karýn aðrýsý nedeniyle acil gözlemde izlenen hastalarýn, klinik spektrumu, fizik baký, laboratuvar ve görüntüleme bulgularýnýn ve seyirlerinin irdelenmesini amaçladýk.
Gereç ve Yöntem: Ocak 2012- Aralýk 2012 tarihleri arasýnda hastanemize akut karýn aðrýsý ile getirilip gözleme alýnan 451 hasta demografik özellikleri, etiyolojileri, fizik baký, laboratuvar ve görüntüleme sonuçlarý ve hastalýðýn gidiþi yönünden dosya kayýtlarýndan geriye dönük olarak incelenmiþtir.
Bulgular: Acil servise baþvuran 94750 hastanýn 3700’ü (%3.9) karýn aðrýsý nedeniyle getirilmiþ olup 451’i (%12.2) acil gözlemde izlenmiþtir. Hastalarýmýzýn yaþ ortalamasý 7.01±1.62 yýl olup kýz erkek oraný 1.6 idi. Karýn aðrýsýna en sýk eþlik eden semptom kusmaydý (%45.4). Hastalarýn %21.5’inde (n=97 hasta) tekrarlayan karýn aðrýsý öyküsü vardý. Tekrarlayan karýn aðrýlý hastalarýn %29.9’unu (n=29 hasta) Ailevi Akdeniz Ateþi tanýlý hastalar oluþturmaktaydý. Laboratuvar bulgularý %74.9 hastada (n=338 hasta) karýn aðrýsý etyolojisini saptamaya ardýmcý olmamýþtý. Hastalarýn %26.82’sine (n=121 hasta) karýn ultrasonografisi (USG) yapýlmýþ olup USG yapýlan hastalarýn %46.7’si (n=64 hasta) normal, %26.2’sinde de (n=36 hasta) mezenterik lenfadenit bulunmuþtu. Hastalarýn %11.6’sýnda (n=51 hasta) cerrahi nedenler saptanmýþtý ve bu nedenler arasýnda en sýk neden akut apandisitti. Cerrahi müdahale gerektiren hastalarýn %71.4’ünde USG bulgularý tanýyý destekliyordu. Hastalarýn %12.6’sýnda (n=57 hasta) karýn aðrýsýnýn nedeni bulunamamýþtý. Cerrahi dýþý nedenler arasýnda akut gastroenteritler ilk sýradaydý. Hastalarýmýzýn %12.8’inin (n=58 hasta) yatýrýlarak izlemine devam edilmiþti.
Sonuç: Acil gözlemde akut karýn aðrýsý nedeniyle izlenen hastalarda cerrahi dýþý nedenler daha fazla gözlenmekteydi. Cerrahi giriþim gerektiren hastalarda USG tanýyý desteklemekteydi.