Diferencia entre revisiones de «Abdominal pain (peds)»

Sin resumen de edición
Línea 3: Línea 3:
*Bilious emesis is a surgical emergency until proven otherwise
*Bilious emesis is a surgical emergency until proven otherwise


== DDX ==
== Differential Diagnosis ==


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Línea 12: Línea 12:
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" rowspan="7" | 0–3 mo old  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" rowspan="7" | 0–3 mo old  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Necrotizing Enterocolitis]]  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Necrotizing Enterocolitis]]  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Colic
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Colic]]
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Volvulus]]  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Volvulus]]  
Línea 18: Línea 18:
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Testicular Torsion]]  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Testicular Torsion]]  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Constipation
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Constipation]]
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Incarcerated hernia  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Incarcerated hernia]]
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
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Línea 26: Línea 26:
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Toxic megacolon  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Toxic megacolon]]
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
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Línea 37: Línea 37:
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Testicular Torsion]]  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Testicular Torsion]]  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Constipation
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Constipation]]
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Trauma  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Trauma  
Línea 48: Línea 48:
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Toxic megacolon  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Toxic megacolon]]
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |  
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
Línea 56: Línea 56:
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" rowspan="14" | 3 y old–adolescence  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" rowspan="14" | 3 y old–adolescence  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Appendicitis]]  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Appendicitis]]  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Constipation
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Constipation]]
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Diabetic Ketoacidosis]]  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Diabetic Ketoacidosis]]  
Línea 62: Línea 62:
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Vaso-occlusive crisis  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Vaso-occlusive crisis  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Nonspecific viral syndromes
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Nonspecific [[viral syndrome]]
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Toxic ingestion  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Toxic ingestion]]
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | ''Streptococcus'' pharyngitis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Streptococcus pharyngitis]]
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Testicular Torsion]]  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Testicular Torsion]]  
Línea 79: Línea 79:
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Cholecystitis]]
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Cholecystitis]]
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Toxic megacolon  
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Toxic megacolon]]
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Renal Stone]]
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Renal Stone]]
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
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Línea 86: Línea 86:
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
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| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |    
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |    
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Inflammatory bowel disease
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Inflammatory bowel disease]]
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |    
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |    
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Gastric ulcer disease/gastritis
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Gastric ulcer disease]]/[[gastritis]]
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |    
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |    
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | Ovarian cyst
| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" | [[Ovarian cyst]]
|- class="font12" style="font-size: 12px; margin: 0px 0px 9px; line-height: 17px"
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| class="font12" style="font-size: 12px; margin: 0px 0px 9px; color: rgb(51,51,51); line-height: 17px" valign="top" align="left" bgcolor="#ffffff" |    

Revisión del 12:13 14 ene 2015

Background

  • Bilious emesis is a surgical emergency until proven otherwise

Differential Diagnosis

Age Emergent Nonemergent
0–3 mo old Necrotizing Enterocolitis Colic
Volvulus Acute Gastroenteritis
Testicular Torsion Constipation
Incarcerated hernia  
Trauma  
Toxic megacolon  
Tumor  
3 mo–3 y old Intussusception Acute Gastroenteritis
Testicular Torsion Constipation
Trauma Urinary Tract Infections
Volvulus HSP
Appendicitis  
Toxic megacolon  
Vaso-occlusive crisis  
3 y old–adolescence Appendicitis Constipation
Diabetic Ketoacidosis Acute Gastroenteritis
Vaso-occlusive crisis Nonspecific viral syndrome
Toxic ingestion Streptococcus pharyngitis
Testicular Torsion Urinary Tract Infections
Ovarian Torsion Pneumonia
Ectopic Pregnancy Pancreatitis
Trauma Cholecystitis
Toxic megacolon Renal Stone
Tumor HSP
  Inflammatory bowel disease
  Gastric ulcer disease/gastritis
  Ovarian cyst
  Pregnancy

Workup

  1. UA, hCG
  2. Chemistry: eval for dehydration
  3. Imaging
    1. Abd xray
      1. Specific, not sensitive
    2. Ultrasound
      1. Appropriate for intussusception, ovarian/testicular, GB, IUP, appy
    3. CT
      1. May be a/w 1/1000 lifetime risk of malignancy

See Also

Source

Gausche 11/03- By Lampe

7/2/09 PANI