J.Jpn. Surg. Soc.. 121(5): 510-516, 2020

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Feature topic

ABDOMINAL PAIN THAT MUST NOT BE OVERLOOKED (EXCLUDING APPENDICITIS)

Abdominal pain in children is a common problem. Among patients complaining of abdominal pain, only 1％ require surgery. However, abdominal pain may indicate a condition requiring surgery and must not be overlooked. Such conditions include impaired organ circulation and generalized peritonitis. Bile or stool-like vomiting is an important sign of ileus. Abdominal pain with no history of surgery or of unknown etiology could indicate internal hernia or intestinal torsion. It should be noted that peritonitis in infants may lack specific findings. Inguinal hernia and testicular torsion are often overlooked because inguinal abnormalities are sometimes not immediately apparent. The most important role of a surgeon in treating acute abdomen is to provide a pathological diagnosis to determine whether surgery is required rather than to make an accurate diagnosis at the first consultation. It is not necessary to make this decision during a single consultation, but it is important to observe changes in patients over time and conduct thorough diagnostic follow-up.

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