Pediatric abdominal pain: A cost effective approach to abdominal pain diagnoses in the emergency department

摘要

Abdominal pain is the most common reason for emergency department visits among children. Children visiting the emergency department often have difficulties in expressing and communicating their pain to the physician which leaves the physician facing the challenge of efficiently and effectively reaching a diagnosis with little information provided by the patient. Two common diagnoses for abdominal pain are appendicitis and constipation. Appendicitis is the most common reason for surgical intervention among patients. Suspicion of appendicitis calls for immediate diagnosis and treatment to the emergent nature of this condition. If appendicitis can be ruled out, the physician must observe for signs of other possible conditions causing the abdominal pain. In otherwise healthy children, constipation is often the diagnosis for abdominal pain. Unlike appendicitis, constipation is not life threatening. Identifying constipation does not require the implementation of costly hospital tests and can be diagnosed through patient assessment and physical examination. In this study we analyzed the importance of biological marker tests and radiologic imaging tests used in the emergency department to determine the value of each and determine an efficient triage to the diagnoses of pediatric abdominal pain in the emergency department. Statistical analysis results show a significant difference between most positive and negative laboratory marker and radiologic imaging tests, thus indicating that most of these examinations are extraneous, costly, and unnecessary in the emergency department. Isolation of appendicitis is crucial for the positive outcome of patients afflicted with this life threatening condition. This study aims to identify a cost effective method to apply to pediatric patients visiting the emergency department complaining of abdominal pain.