Age group | Cause of pain | Diagnostic clues |
---|
* Diseases needing surgical treatment are indicated with an asterisk. |
0-2 years | Pyloric stenosis* | Jet-like vomiting; age 2-8 weeks |
| Invagination* | Paroxysmal pain, some diarrhoea, "meat water" and empty rectal ampulla at DRE |
| Incarcerated hernia* | Reposition is neither easy nor successful |
| Testis torsion* | Testicular pain, visible swelling (but intra-inguinal torsion is possible in retention) |
| Gastroenteritis | Diarrhoea or vomiting are the first and dominant symptoms |
| Otitis media | Ear status |
| Urinary tract infection or other serious infection | Fever and vomiting without evident diarrhoea; urine test |
3-11 years | Appendicitis* | Transfer of pain, pin-point tenderness, jumping test |
| Dolores abdominis NUD | The most common entity; important to differentiate from appendicitis |
| Mesenterial lymphadenitis | Clues do not differ from those of appendicitis |
| Gastroenteritis | Diarrhoea at onset, non-existent or slight tenderness on palpation |
| Constipation | History, hard stools; pain is often severe |
| Pneumonia | Cough, findings on auscultation, chest radiograph |
| Sinusitis | Local symptoms, ultrasonography, sinus radiograph |
| Tonsillitis | Inspection of the pharynx |
| Urinary tract infection | Urine test |
| Henoch-Schönlein purpura | Petechial rash |
>11 years | Appendicitis* | See above |
| Gastroenteritis | See above |
| Salpingitis | Only in the sexually active |
| Ovarian cyst | May burst at exertion |
| Urinary tract infection | Urine test |