Abdominal distension

In the newborn period, a perforation in the alimentary or urin­ary tract should be considered, as well as tumours, cysts and hydronephrosis. Perforation of the stomach is manifested by abdominal distension, vomiting, respiratory distress and mcl-acna, usually around the third day of life. A perforation in the urinary tract, causing ascites, is usually the result of urethral obstruction. One of the features of chloramphenicol toxicity in the newborn (the grey syndrome) is abdominal distension, as­sociated with cyanosis and pallor. In Hirschsprung's disease there is usually abdominal distension, often with alternating constipation and diarrhoea.

When the child is older abdominal distension, more than that commonly seen in the normal toddler, may be due to stcatorr-hoea, gross constipation, ascites or tumour. Diphenoxylate (Lomotil) should not be used in children but can be a cause of otherwise unexplained distension.

Intestinal obstruction may present with abdominal pain (with or without vomiting) and some localized distension of the abdomen (see the section on acute abdominal pain above).