Pediatric emergency care
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Acute pancreatitis in childhood is not a rare condition, and it should be considered in all children presenting with acute abdominal complaints. A complete history should be obtained, with emphasis on recent trauma or infection, current medications, and the presence of any chronic diseases. ⋯ Appropriate aggressive treatment, instituted early, will help to reduce the associated morbidity and mortality. Most children with acute pancreatitis will recover with conservative management and suffer no significant long-term sequelae.
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We undertook a prospective study of 377 children (two to 16 years old) presenting with abdominal pain to determine: 1) common discharge diagnoses; 2) what signs and symptoms are associated with appendicitis; and 3) follow-up of patients discharged from the emergency department (ED). Nine diagnoses accounted for 86% of all diagnoses made. The most common final diagnosis was "abdominal pain" (36%). ⋯ Of the patients contacted within one week of the visit (237), 75% reported that the pain had resolved (mean contact time, 2.6 days). We conclude that 1) patients presenting to the ED with abdominal pain often leave with the diagnosis of abdominal pain; 2) of the patients contacted, the majority reported that their pain has resolved; and 3) a diagnosis of appendicitis should be considered in any patient with any two of the following signs or symptoms: vomiting, guarding, tenderness, or RLQ pain. Such patients should be evaluated and observed carefully for the possible diagnosis of appendicitis.