Presentation

Abdominal Pain / Abdominal Mass

Key Conditions

Key conditions are the core conditions that the Paediatric Undergraduate and Clerkship Directors of Canada (PUPDOC) felt are essential for graduating medical students to know. The Key Conditions are neither a differential diagnosis nor a clinical approach. They highlight conditions that may be unique to paediatrics, that are essential, or that are common. Key Conditions can present in a number of ways – each is listed as under the most common Clinical Presentation.

Clinical Approach

Clinical approaches represent one of many methods to think through a clinical presentation, and narrow down a differential diagnosis. There are many conditions that can present with similar symptomatology. These presentations are not meant to contain an exhaustive list of differential diagnoses, but rather outline how to think through patient signs and symptoms, and understand some of the most common and important Paediatric conditions. There are many different ways to approach any clinical presentation, and these approaches are not meant to replace clinical judgement.

Vignette

A 5 year old boy is brought to the emergency department with complaints of worsening abdominal pain

Diagrams

Pre-Clerkship

Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.

Lectures

Small Groups

Clerkship

Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.

Objectives

By the end of the Paediatric Clerkship, a medical student will be able to:

  1. Clinically recognize and propose an investigation and management plan for patients with appendicitis, constipation and functional abdominal pain.
  2. Recognize the clinical features of neuroblastoma, ovarian torsion, pregnancy and Wilm's tumor.

Half Day Cases

  • A 4 year old boy presents with a 12 hour history of abdominal pain
  • A 12 year old girl presents with a 6 month history of chronic abdominal pain
  • A 6 year old boy with chronic abdominal pain presents with infrequent stooling
  • A 3 year old boy presents with a 1.5 year history of non-bloody diarrhea (3-4 loose stools per day)

Resources

The following resources have been reviewed and collated by canuc-paeds. These resources are aimed to provide information at the level of the medical student. These include overviews of topics, clinical resources, and useful guidelines that contain relevant materials.

Papers 

  • Acute Abdominal Pain. Ross A et al.
    Pediatrics in Review 2010-08-17 17:43; 31: 135-144.
    Overview on acute abdominal pain. Focus on history, physical and differential diagnosis.
  • Chronic Abdominal Pain. Collins BS et al.
    Pediatrics in Review 2007-08-17 17:43; 28: 323–331.
    Review article on chronic abdominal pain focusing on functional causes of abdominal pain.
  • Managing functional constipation in children.
    http://www.cps.ca/documents/position/functional-constipation
    Canadian Paediatric Society Position Statement (2011-08-17 17:43) on constipation.

Videos 

No videos.