Non Surgical Causes of Acute Abdomen in Children: Surgeons Standpoint for Exclusion

Abstract

Objectives: The aim of this study is to find out the non-surgical causes of acute abdomen, their frequencies, and to make an algorithm to make a methodology for excluding surgical abdomen. Methodology:  This descriptive case series study was carried out in departments of pediatrics and surgery in Aero hospital from January 2021 to November 2022. One hundred children with acute abdomen who were referred for surgical opinion and found to have non-surgical abdomen were included in the study. Surgical causes were ruled out after serial examinations and investigations by consultant surgeons. All non-surgical causes, their frequencies of presentation were recorded and an algorithm was made. Descriptive data was analyzed using SPPS version 25. Results: Gastroenteritis was found to be the most important cause of non-surgical acute abdomen and found in 23% (n=23) children followed by 18% (n=18) mesenteric lymphadenitis, nonspecific abdominal pain 12% (n=12), UTI 7% (n=7), worm infestation 7% (n=7), enteric ileitis 06% (n=6), Covid 05% (n=5), hepatitis 05%(n=5), constipation 04% (n=4), dengue 4% (n=4), ruptured ovarian follicle 3% (n=3), renal calculi 2% (n=2), Henoch schonlein purpura 2% (n=2) and gastritis 2% (n=2). An algorithm also made at the end of study to help treating surgeons to rule out surgical abdomen. Conclusion: Gastroenteritis is the leading cause of acute non-surgical abdomen in children along with many other causes and these must be carefully ruled out by an algorithm to avoid unnecessary surgeries.