Acute non-traumatic abdominal pain in childhood at Kenyatta National Hospital, Kenya

Abstract

Background The assessment and diagnosis of acute abdominal pain in childhood is clinically challenging. The epidemiologic correlates differ for different paediatric age groups and settings. Objectives To determine the clinical spectrum of acute abdominal pain in childhood at a referral Kenyan public hospital. Design Cross-sectional observational prospective study of 390 children presenting at the paediatric filter Clinic and wards at Kenyatta National Hospital. Results Boys were majority (62.4%). The mean patient age was 4.3 years. One hundred and thirty one patients (33.6%) were admitted and 74 of these (56.5%) underwent surgery. Majority of the children presented after 48 hours of onset of the abdominal pain. Surgical causes constituted 14% of all cases seen in the filter clinic. The most common causes of surgical abdominal pain were intussusceptions (25.7%) and appendicitis (30%) in infants and children > 6 years of age respectively. Of non surgical causes, upper respiratory tract infections (21%), gastroenteritis (15.6%) and non-specific abdominal pain (9.2%) predominated. Conclusions Medical causes are the leading cause of Acute Abdominal Pain in our locality but important and life threatening surgical causes must be recognized. Intususception is a leading diagnosis in the infant while appendicitis is a top etiology in older children. History and physical examination remain the cornerstones in the approach to a patient with acute abdominal pain.