Elsevier

The Journal of Pediatrics

Volume 151, Issue 6, December 2007, Pages 666-669
The Journal of Pediatrics

Original article
Constipation as Cause of Acute Abdominal Pain in Children

https://doi.org/10.1016/j.jpeds.2007.05.006Get rights and content

Objective

To evaluate the causes of acute abdominal pain in a large academic pediatric primary care population.

Study design

The complete charts of 962 children, ≥4 years old, who were seen for at least 1 health maintenance visit during a 6-month period, were reviewed retrospectively for complaints and cause of acute abdominal pain.

Results

We found that 9% of the 962 children had a visit for acute abdominal pain, with significantly more girls (12%) than boys (5%) having this complaint. Acute and chronic constipation were the most frequent causes of acute abdominal pain, occurring in 48% of subjects. A surgical cause was present in 2% of subjects. The cause for the acute abdominal pain remained unknown in 19% of subjects. We did not find significant differences in diagnoses in the primary care clinics versus emergency department.

Conclusions

We found that constipation was the most common cause of acute abdominal pain in children.

Section snippets

Study Population

The study population was selected by including all children, 4 to 17.9 years old, who attended the primary pediatric clinics at the Children’s Hospital of Iowa at the University of Iowa for at least 1 health maintenance visit, during a 6-month period from January 2 to June 30, 2004. To identify these children, a computer search was performed with the codes 99382, 99392, 99383, 99393, 99384, and 99394 from the Current Procedure Terminology for initial and return well child visits. Children who

Results

The computer identified 1002 children, 4 to 17.9 years old. Forty children were excluded because of chronic diseases, such as cerebral palsy with severe mental retardation, severe mental retardation caused by chromosomal abnormalities, severe cardiac abnormalities with surgical procedures such as cardiac transplant or pacemaker implantation, and 1 child with ulcerative colitis diagnosed in infancy because of bloody stools. The charts of 962 children (493 boys, 469 girls) with a mean age of 9.1

Discussion

In our study population served by our primary care clinics, acute abdominal pain was a reason for the visit to the acute clinic or the emergency department in 9% of 962 children, 4 to 17.9 years old. Acute abdominal pain affected girls (12.2%) significantly more often than boys (5.3%). We found constipation to be the most frequent cause for the acute abdominal pain (48%). Acute constipation in 13% of cases and chronic constipation in 35% of cases were associated with acute abdominal pain severe

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