Diagnosis And Treatment Of Abdominal Pain In 679 Children In Dali Hospital

Objective:We analyzed the clinical data of children admitted to the First Affiliated Hospital of Dali University with abdominal pain as the main complaint,and analyzed the etiology and characteristics of pediatric abdominal pain to provide reference for clinical workers in identifying the etiology of pediatric abdominal pain and taking timely treatment measures to protect children’s health.Methods:1.The clinical data of children hospitalized with abdominal pain as the main complaint in the First Affiliated Hospital of Dali University from January 2019 to December 2021 were collected through the hospital management system,and a total of 679 cases meeting the（inclusion）criteria were analyzed and summarized for the etiology of abdominal pain.2.Statistical results were analyzed statistically using SPSS24.0 statistical software.Statistical data were expressed as number of cases（n）and composition ratio（%）,and comparison between groups was performed by Pearson test or continuous correction method,and those who did not meet the former condition were analyzed by Fisher’s exact probability method.P< 0.05 was considered statistically significant difference,and two-by-two comparison between groups required correction test level of α’;multiple rates were compared by row × column chi-square test.P < 0.05 was considered statistically significant as the test criterion.Results:1.Among the causes of abdominal pain,appendicitis was the main cause with244 cases（35.9%）,followed by allergic purpura with 103 cases（15.2%）,intestinal obstruction with 52 cases（7.7%）in the third place,chronic gastritis with 34 cases（5.0%）in the fourth place,mesenteric lymphadenitis with 29 cases（4.3%）in the fifth place,and other causes were acute pancreatitis with 27 cases（4.0%）,intussusception26 cases（3.8%）,gallbladder and biliary system disease 22 cases（3.2%）,acute gastroenteritis 16 cases（2.3%）,abdominal trauma 1.Among 679 cases of children with abdominal pain,there were 386 boys and 299 girls,with a male to female ratio of1.29:1.48 cases were in the early childhood group（1-3 years old）,191 cases in the preschool group（3-7 years old）,205 cases in the school age group（7-10 years old）,and 236 cases in the adolescent group（10-14 years old）.14 cases（2.1%）,tumor14 cases（2.1%）,bacterial intestinal infection 12 cases（1.8%）,constipation 12 cases（1.8%）,urinary tract infection 8 cases（1.2%）,peptic ulcer 6 cases（0.9%）,Meckel’s diverticulum 5 cases（0.7%）,urinary stones 4 cases（0.6%）,functional abdominal pain4 cases（0.6%）,ureteral stenosis with hydronephrosis 4 cases（0.6%）,giant colon-like margin disease 3 cases（0.4%）,intra-abdominal hernia 3 cases（0.4%）,testicular torsion 3 cases（0.4%）,in addition,unexplained abdominal pain 18 cases（2.7%）,other diseases 16 cases（6.6%）.Among the concomitant symptoms,besides abdominal pain,there were 304 cases of vomiting,162 cases of nausea,136 cases of fever,83 cases of rash,39 cases of abdominal distension,27 cases of arthralgia,1 case of painful urination,1 case of polydipsia and polyuria,1 case of rhinorrhea,and 1 case of urinary tract irritation sign.2.The top three causes of abdominal pain in the adolescent group were acute appendicitis,allergic purpura,acute pancreatitis,and chronic gastritis（40.3%,11.9%,and 6.4% each,respectively）,and among the concomitant symptoms in different age groups: the top three most common concomitant symptoms in the early childhood group were vomiting,fever,and abdominal distention（50.0%,43.8%,and 10.5%,respectively）.The top three concomitant symptoms in the preschool group were vomiting,fever,and nausea（53.2%,28.4%,and 27.4%,respectively）;the most common concomitant symptoms in the school-age group were vomiting,rash,and nausea（42.0%,21.5%,and 19.5%,respectively）;the top three concomitant symptoms in the adolescent group were Vomiting,nausea,and fever（39.4%,28.8%,and 12.7%,respectively）.3.There were no statistically significant differences in the distribution of appendicitis,allergic purpura,intestinal obstruction,chronic gastritis,and mesenteric lymphadenitis by gender（P > 0.05）;statistically significant differences in the distribution of appendicitis by age,season,ethnicity,region,and stool changes（P <0.05）;statistically significant differences in the distribution of allergic purpura by age,ethnicity,region,and stool changes（P < 0.05）,and no statistically significant differences in the distribution of seasonal There were statistically significant differences in age,seasonal and geographical distribution of intestinal obstruction（P< 0.05）and no statistically significant differences in stool changes;there were statistically significant differences in age and seasonal distribution of chronic gastritis（P < 0.05）and no statistically significant differences in ethnicity,geographical distribution and stool changes（P > 0.05）,and intestinal mesenteric Lymphadenitis was statistically significant in age distribution（P < 0.05）,but not in seasonal,ethnic,geographical,and stool distribution（P > 0.05）.Conclusion:1.The first three main causes of abdominal pain in children at the First Affiliated Hospital of Dali University are: appendicitis,allergic purpura,and intestinal obstruction.2.The main cause of abdominal pain in young children is intestinal obstruction,and appendicitis is the primary cause of abdominal pain in preschool-age,school-age and adolescent children.3.In addition to abdominal pain,other accompanying symptoms include nausea,vomiting,fever,abdominal distention,rash,etc.In northwest Yunnan,appendicitis and allergic purpura are distributed differently in ethnic and geographical areas.