Teen Amateur Pain
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Affiliation
1 Division of Pediatric Surgery, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands. k.t.buddingh@chir.umcg.nl
K Tim Buddingh et al. J Pediatr Gastroenterol Nutr. 2012 May.
Affiliation
1 Division of Pediatric Surgery, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands. k.t.buddingh@chir.umcg.nl
Objective: The aim of this study was to describe the discharge diagnoses of children receiving surgical consultation for acute abdominal pain according to age and sex.
Methods: Retrospective chart review.
Results: Nine hundred forty-one children were included. Appendicitis was confirmed in 31% of young boys (<12 years), 42% of teenage boys (≥12 years), 38% of young girls, and only 18% of teenage girls. A large number of teenage girls were diagnosed as having constipation and nonspecific abdominal pain. Gynecological diagnoses were relatively rare (9% of teenage girls). Teenage girls often required multiple visits to the emergency department. In addition, they frequently received consultation from other medical specialists: 30% versus 20% of young girls and 12% of boys. Teenage girls had the highest rate of (retrospectively) unnecessary surgery: 36% versus 10% of young girls (P < 0.01) and 11% of boys (P < 0.01).
Conclusions: Most children receiving surgical consultation for acute abdominal pain do not have diseases requiring surgery. In teenage girls, especially, the proportion with appendicitis is low. Constipation and nonspecific abdominal pain are the main discharge diagnoses in this group. Physicians should have a high index of suspicion of constipation when examining teenage girls with acute abdominal pain.
Loening-Baucke V, Swidsinski A. Loening-Baucke V, et al. J Pediatr. 2007 Dec;151(6):666-9. doi: 10.1016/j.jpeds.2007.05.006. Epub 2007 Jul 30. J Pediatr. 2007. PMID: 18035149
Caperell K, Pitetti R, Cross KP. Caperell K, et al. Pediatrics. 2013 Jun;131(6):1098-106. doi: 10.1542/peds.2012-3672. Epub 2013 May 20. Pediatrics. 2013. PMID: 23690514
Klein MD, Rabbani AB, Rood KD, Durham T, Rosenberg NM, Bahr MJ, Thomas RL, Langenburg SE, Kuhns LR. Klein MD, et al. J Pediatr Surg. 2001 Sep;36(9):1375-80. doi: 10.1053/jpsu.2001.26374. J Pediatr Surg. 2001. PMID: 11528609
McCollough M, Sharieff GQ. McCollough M, et al. Pediatr Clin North Am. 2006 Feb;53(1):107-37, vi. doi: 10.1016/j.pcl.2005.09.009. Pediatr Clin North Am. 2006. PMID: 16487787 Review.
Härkki P, Heiskanen K. Härkki P, et al. Duodecim. 2005;121(17):1889-98. Duodecim. 2005. PMID: 16262132 Review. Finnish. No abstract available.
Timmerman MEW, Trzpis M, Broens PMA. Timmerman MEW, et al. BMJ Paediatr Open. 2018 Nov 9;2(1):e000341. doi: 10.1136/bmjpo-2018-000341. eCollection 2018. BMJ Paediatr Open. 2018. PMID: 30498795 Free PMC article. Review.
Allen LN, Tsai AY. Allen LN, et al. BMJ Case Rep. 2016 Jun 30;2016:bcr2016214944. doi: 10.1136/bcr-2016-214944. BMJ Case Rep. 2016. PMID: 27364910 Free PMC article.
Rhondali W, Nguyen L, Palmer L, Kang DH, Hui D, Bruera E. Rhondali W, et al. J Pain Symptom Manage. 2013 Jan;45(1):23-32. doi: 10.1016/j.jpainsymman.2012.01.009. Epub 2012 Jul 25. J Pain Symptom Manage. 2013. PMID: 22835482 Free PMC article.
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