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Description

Hyams et al listed findings that should cause concern in a pediatric patient with chronic abdominal pain. These can help to identify a patient who may benefit from a more aggressive evaluation. The authors are from Connecticut Children's Medical Center, Nationwide Children's Hospital Columbus, Texas Children's Hospital, University of Naples and the University of North Carolina at Chapel Hill.


Patient selection: pediatric patient with chronic abdominal pain

 

Alarm findings include:

(1) family history of inflammatory bowel disease

(2) family history of celiac disease

(3) family history of peptic ulcer disease

(4) persistent right upper or right lower quadrant pain

(5) dysphagia

(6) odynophagia (painful swallowing)

(7) persistent vomiting

(8) gastrointestinal bleeding

(9) nocturnal diarrhea

(10) arthritis

(11) perirectal disease

(12) involuntary weight loss

(13) deceleration of linear growth

(14) delayed puberty

(15) fever of unknown origin (FUO)

 

where:

• Failure to thrive be added to deceleration of linear growth


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