Acute abdominal pain in children: an analysis of admissions over a three year period.

A quality audit was performed of the case records of 1313 children admitted with acute abdominal pain over a three year period under the care of paediatric surgeons at the Princess Margaret Hospital for Children, Perth. Fifty-four per cent (n = 714) of the patients were discharged without surgical intervention; in this group the most frequent (70%, n = 503) diagnosis was non-specific abdominal pain (NSAP). Of those children having surgery, 74% (n = 443) had appendicitis proven on histopathology; the remaining appendices (n = 134) were reported as normal and no other surgical cause for the patients symptoms were identified. Only 3.7% (n = 22) of children having surgery had another surgical cause for their pain. Of this group, 11 had adnexal pathology, eight had complications of a Meckel's diverticulum and three had torsion of the omentum. There were no deaths in this series, and 39 patients (3%) had wound infections. Based on these results, only 35% of children referred to a surgeon with abdominal pain will actually require surgical intervention, although as a consequence of concern over clinical status an additional 10% will have a laparotomy with normal findings.