Medical Council of Canada

Medical expert

Abdominal Pain (Children) - 3-1

Rationale

Abdominal pain is a common complaint in children. While the symptoms may result from serious abdominal pathology, in a large proportion of cases, an identifiable organic cause is not found. The causes are often age dependent.

Causal Conditions

(list not exhaustive)
  1. Lower abdominal
    1. Appendicitis
    2. Constipation
    3. Gastroenteritis
    4. Mesenteric lymphadenitis
    5. Inflammatory bowel disease
    6. Inguinal hernia (incarcerated)
    7. Urinary tract infection
    8. Gynecological cause in pubertal children
  2. Generalized pain
    1. Peritoneal inflammation
    2. Bowel
      1. Infantile colic
      2. Obstruction
    3. Malabsorption
    4. Irritable bowel syndrome
  3. Flank pain
    1. Pyelonephritis
    2. Kidney stones
  4. Periumbilical recurrent abdominal pain
  5. Epigastric pain
    1. Gastroesophageal reflux
    2. Peptic ulcer
    3. Biliary tract disease
    4. Pancreatitis

Key Objectives

In particular, the candidate will distinguish those patients requiring emergency medical and/or surgical treatment, recognizing that a non-organic cause is the most common etiology for the symptoms.

Enabling Objectives

Given a pediatric patient with abdominal pain, the candidate will

  1. list and interpret critical findings, including those derived from
    1. a. the identification of causes of abdominal pain requiring surgery (this requires particular attention to a thorough physical examination aimed at findings suggestive of peritonitis);
    2. b. the differentiation of all possible psychological causes or psychosocial circumstances in case of chronic abdominal pain;
    3. c. the differentiation between organic pain and infantile colic;
  2. list and interpret critical investigations, including
    1. laboratory investigations and diagnostic imaging;
  3. construct an effective initial management plan, including
    1. determining whether emergency surgical or medical care is required;
    2. outlining the initial plan of management in case of acute intestinal obstruction;
    3. outlining a plan of management for common causes of abdominal pain based on age;
    4. determining whether specialized care and/or further investigations are required.
    5. determining whether psychosocial issues need to be addressed.
Next: Acute Abdominal Pain