Pediatrics International (2004) 46, 325–329 Original Article Clinical spectrum of acute abdominal pain in Turkish pediatric patients: A prospective study TÜLAY ERKAN, 1 HALIT ÇAM, 2 HILDA ÇERÇI ÖZKAN, 1 EVRIM KIRAY, 1 ETHEM ERGINOZ, 3 TUFAN KUTLU, 1 YUCEL TASTAN 2 AND FUGEN ÇULLU 1 1 Department of Pediatrics, Division of Gastroenterology, 2 Division of Emergency Unit and Department of Public Health and 3 Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey Abstract Background: The aim of the present study was to determine the prevalence, associated symptoms, and clinical outcomes of children with acute abdominal pain who had been admitted to an emergency department. Methods: Children aged between 2 and 16 years who presented to the emergency department of Cerrahpala Medical School, Istanbul University between July 2001 and August 2002 with acute abdominal pain were enrolled in this study. A questionnaire was completed each patient admitted to our pediatric emergency unit for acute abdominal pain. Data collected included presenting signs and symptoms, the hospital follow up for all children who returned within 10 days, test results, and telephone follow up. Results: The number of children referred to the emergency department was 7442, with 399 (5.4%) of these having acute abdominal pain. The mean age of the study population was 6.9 ± 3.5 years, and 201 of the patients were male. The five most prevalent diagnoses were: (i) upper respiratory tract infection and/or complicated with otitis media or sinusitis (23.7%); (ii) abdominal pain with uncertain etiology (15.4%); (iii) gastroenteritis (15.4%); (iv) constipation (9.4%); and (v) urinary tract infection (8%). The most common associated symptoms were decreased appetite, fever and emesis. Because of follow-up deficiency the progress of 28 patients was not obtained. Eighty-two children were referred to the department of pediatric surgery, but only 17 of 82 (20.7%) required surgical intervention (15 of these 17 for appendicitis). Eleven patients returned within 10 days for re-evaluation, but the initial diagnosis was not changed. The complaints of 57 patients with uncertain etiology were resolved within 2 days. Conclusions: An acute complaint of abdominal pain was usually attributed to a self-limited disease. However, the percentage of surgical etiology is not negligible. Key words acute abdominal pain, child, pediatric emergency. Acute abdominal pain is a common problem in childhood. 1–3 The possible causes are varied and numerous. Some problems are self-limiting, while others can be life-threatening. The assessment and diagnosis of acute abdominal pain in child- hood continues to be a clinical challenge. Generally, it is accepted that acute abdominal pain prevents personal activity and has an unexpected onset. In the majority of cases vomiting accompanies abdominal pain. Scholer et al. showed that the prevalence of children aged 2–12 years presenting with abdominal pain of ≤3 days’ duration was 5.1%. 4 In the same study, the prevalence of children over 2 years of age with abdominal pain of any duration was 8.1%. An initial, carefully performed history and physical examination, should differentiate the child who has a surgical disease from one who requires medical therapy or only reassurance. In this study, we present the results of a prospective study in the evaluation of clinical and associated symptoms generally observed, and the clinical outcomes, of children with acute abdominal pain admitted to a pediatric emergency department. Methods Children aged between 2 and 16 years who were admitted to the pediatric emergency department of Cerrahpasa Medical School in Istanbul between July 2001 and August 2002 for Correspondence: Tülay Erkan, Visnezade mah. Kireçhane sok. Türker apt. no:9/4, Besiktas 80 690 Istanbul, Turkey. Email: tulerkan@hotmail.com.tr Received 3 March 2003; revised 20 August 2003; accepted 14 October 2003.