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An Atypical Case of Abdominal Pain in a Toddler

A Diagnostic Challenge

Jordan, Kathleen S. DNP, RN, FNP-BC, ENP-C, SANE-P, FAEN, FAANP

Section Editor(s): Jordan, Kathleen S. DNP, RN, FNP-BC, ENP-C, SANE-P, FAEN, FAANP; Column Editor

doi: 10.1097/TME.0000000000000248
CASES OF NOTE
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Abdominal pain in the pediatric patient presents a unique diagnostic challenge for emergency department (ED) providers due to the wide range of possible etiologies and sequelae. The list of differential diagnoses is extensive and includes the spectrum of conditions that range from benign and self-limiting to those that are potentially life-threatening. This article describes a case of a young toddler with an acute appendicitis complicated by perforation and abscess formation. Although acute appendicitis is uncommon in infants and younger children, it does occur and, as this case illustrates, is often misdiagnosed, which leads to delayed treatment and a higher incidence of complications. This article includes a discussion of the challenges faced by ED providers in the clinical-decision making process when caring for a pediatric patient with abdominal pain due to an acute appendicitis. This discussion includes the age-associated epidemiology, pathophysiology, clinical presentation, and evidence-based recommendations for diagnosis and treatment.

The University of North Carolina at Charlotte, Charlotte, North Carolina; and Mid-Atlantic Emergency Medicine Associates, Charlotte, North Carolina.

Corresponding Author: Kathleen S. Jordan, DNP, RN, FNP-BC, ENP-C, SANE-P, FAEN, FAANP, 3839 Swanson Rd, Sherrills Ford, NC 28673 (ksjorda1@uncc.edu).

Disclosure: The author reports no conflict of interest.

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