General principles
Acute appendicitis
It would be much easier for the doctor if all children with acute appendicitis had the symptoms of abdominal pain, vomiting, constipation and fever, the pain commencing in the umbilical area and settling down in the right iliac fossa. Unfortunately the diagnosis is often more difficult. In several studies it was found that about 10% have dysuria (and there may be an excess of white cells and some albumin in the urine) and about 10% have diarrhoea. Appendicitis can occur at any age, and infants with acute appendicitis usually present with diarrhoea, urinary symptoms and an abdominal mass, often with acetone in the urine, and the white cell count may be normal, though this is unusual. In 40% of 100 cases of perforated appendix, there had been no localization of pain. When the appendix is rctrocaecal, the pain may be in the upper part of the abdomen on the right, or not localized. Occasionally the pain may be in the left iliac fossa. In some cases there is no pain at all. The temperature is not usually high, but may be over 39c in an occasional case.
It may be difficult or impossible to distinguish acute appendicitis from acute
It would be much easier for the doctor if all children with acute appendicitis had the symptoms of abdominal pain, vomiting, constipation and fever, the pain commencing in the umbilical area and settling down in the right iliac fossa. Unfortunately the diagnosis is often more difficult. In several studies it was found that about 10% have dysuria (and there may be an excess of white cells and some albumin in the urine) and about 10% have diarrhoea. Appendicitis can occur at any age, and infants with acute appendicitis usually present with diarrhoea, urinary symptoms and an abdominal mass, often with acetone in the urine, and the white cell count may be normal, though this is unusual. In 40% of 100 cases of perforated appendix, there had been no localization of pain. When the appendix is rctrocaecal, the pain may be in the upper part of the abdomen on the right, or not localized. Occasionally the pain may be in the left iliac fossa. In some cases there is no pain at all. The temperature is not usually high, but may be over 39c in an occasional case.
It may be difficult or impossible to distinguish acute appendicitis from acute
mesenteric lymphadenitis.
Intsussuception
If all children with intussusception were aged three to nine months, had had severe rhythmical attacks of abdominal pain, vomiting and pallor, with blood in the stool and a palpable sausageshaped mass, the diagnosis would be easier. Unfortunatelythere are many variations from this picture: there may be a normal bowel action on the first day, or even diarrhoea; there is often no blood in the stool; in 10% or more there is no pain, but attacks of severe pallor with or without vomiting; and in 10% there is a history of a preceding upper respiratory tract infection; in 10% there may be a high white cell count; and in about 15% the temperature is raised.
When a child is said to have had one or more attacks of 'looking awful' and perhaps going limp, it is often difficult to decide whether the cause is something like intussusception or if he has had a fit
If all children with intussusception were aged three to nine months, had had severe rhythmical attacks of abdominal pain, vomiting and pallor, with blood in the stool and a palpable sausageshaped mass, the diagnosis would be easier. Unfortunatelythere are many variations from this picture: there may be a normal bowel action on the first day, or even diarrhoea; there is often no blood in the stool; in 10% or more there is no pain, but attacks of severe pallor with or without vomiting; and in 10% there is a history of a preceding upper respiratory tract infection; in 10% there may be a high white cell count; and in about 15% the temperature is raised.
When a child is said to have had one or more attacks of 'looking awful' and perhaps going limp, it is often difficult to decide whether the cause is something like intussusception or if he has had a fit
Torsion of the testis
This occurs at any age including infancy: the pain may be abdominal or scrota! and often in the groin. An acute painful swelling in the scrotum should be diagnosed as torsion of the testisuntil proved otherwise, and referred urgently to the surgeon for exploration
This occurs at any age including infancy: the pain may be abdominal or scrota! and often in the groin. An acute painful swelling in the scrotum should be diagnosed as torsion of the testisuntil proved otherwise, and referred urgently to the surgeon for exploration
Pain from the urinary tract
The causes include pyelonephritis, hydronephrosis, renal calculus and acute nephritis. The latter can cause abdominal pain.
The causes include pyelonephritis, hydronephrosis, renal calculus and acute nephritis. The latter can cause abdominal pain.
Other causes of acute abdominal pain
These include pneumonia and pleurisy (pain being referred to ihe abdomen), infective hepatitis, Meckel's diverticulitis, acute rheumatic fever, sickle cell anaemia, anaphylactoid purpura, and diabetes or associated hypoglycacmia. A pancreatic pseudocyst may develop around a monih after an upper abdominal injury, causing pain and vomiting.
These include pneumonia and pleurisy (pain being referred to ihe abdomen), infective hepatitis, Meckel's diverticulitis, acute rheumatic fever, sickle cell anaemia, anaphylactoid purpura, and diabetes or associated hypoglycacmia. A pancreatic pseudocyst may develop around a monih after an upper abdominal injury, causing pain and vomiting.
Investigations
These must depend on the history and examination, but the most useful ones will usually be microscopy of urine and culture, and a blood count. If there is a possibility of obstruction, erect and supine views of the abdomen may show fluid levels. Do not treat as a urinary tract infection until it has been proved to be one.
These must depend on the history and examination, but the most useful ones will usually be microscopy of urine and culture, and a blood count. If there is a possibility of obstruction, erect and supine views of the abdomen may show fluid levels. Do not treat as a urinary tract infection until it has been proved to be one.
cihuahua
ReplyDeletePenyakit Tipes
Penyakit Menular
Gejala Penyakit Pneumonia
Gejala Mata Minus
Gejala Asam Lambung
Gejala Penyakit Maag
Cara Menggemukan Badan
Gejala Penyakit Batuk
Obat Paru Paru Basah
Obat alami paru paru basah
Pengobatan Paru Paru Basah
Tentang Kesehatan
cihuahua
ReplyDeletePenyakit Tipes
Penyakit Menular
Gejala Penyakit Pneumonia
Gejala Mata Minus
Gejala Asam Lambung
Gejala Penyakit Maag
Cara Menggemukan Badan
Gejala Penyakit Batuk
Obat Paru Paru Basah
Obat alami paru paru basah
Pengobatan Paru Paru Basah
Tentang Kesehatan