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Constipation and Nonspecific Abdominal Pain in Teenage Girls Referred for Emergency Surgical Consultation

Buddingh, K. Tim; Wieselmann, Eva; Heineman, Erik; Broens, Paul M.A.

Journal of Pediatric Gastroenterology & Nutrition: May 2012 - Volume 54 - Issue 5 - p 672–676
doi: 10.1097/MPG.0b013e31823c253c
Original Articles: Gastroenterology

Objective: The aim of this study was to describe the discharge diagnoses of children receiving surgical consultation for acute abdominal pain according to age and sex.

Methods: Retrospective chart review.

Results: Nine hundred forty-one children were included. Appendicitis was confirmed in 31% of young boys (<12 years), 42% of teenage boys (≥12 years), 38% of young girls, and only 18% of teenage girls. A large number of teenage girls were diagnosed as having constipation and nonspecific abdominal pain. Gynecological diagnoses were relatively rare (9% of teenage girls). Teenage girls often required multiple visits to the emergency department. In addition, they frequently received consultation from other medical specialists: 30% versus 20% of young girls and 12% of boys. Teenage girls had the highest rate of (retrospectively) unnecessary surgery: 36% versus 10% of young girls (P < 0.01) and 11% of boys (P < 0.01).

Conclusions: Most children receiving surgical consultation for acute abdominal pain do not have diseases requiring surgery. In teenage girls, especially, the proportion with appendicitis is low. Constipation and nonspecific abdominal pain are the main discharge diagnoses in this group. Physicians should have a high index of suspicion of constipation when examining teenage girls with acute abdominal pain.

Division of Pediatric Surgery, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.

Address correspondence and reprint requests to K.T. (Tim) Buddingh, MD, Division of Pediatric Surgery, Department of Surgery, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands (e-mail: k.t.buddingh@chir.umcg.nl).

Received 23 July, 2011

Accepted 5 October, 2011

The authors report no conflicts of interest.

Copyright 2012 by ESPGHAN and NASPGHAN