Abstract
The notes and pitfalls in the initial examination of pediatric acute abdomen are summarized in the present article according to a review of our own experience. In our series, acute appendicitis, intussusception, ileus, and biliary dilatation accounted for more than 95% of the patients hospitalized because of acute abdomen. In addition, the signs and symptoms had a wide variation in these diseases in the pediatric population. These observations suggested that the above four common diseases should be kept in mind any time when examining pediatric patients with acute abdomen even though their clinical features look atypical. On the other hand, the primary survey in cases of acute abdomen should be directed to arrive at the decision whether an urgent laparotomy is necessary. The decision should be made with the highest priority preceding the differential diagnosis of the abdominal pain. Therefore, close cooperation between pediatricians and pediatric surgeons is absolutely be mandatory for an appropriate diagnosis and treatment of pediatric acute abdomen. A regional emergency medical system needs to be constructed in consideration of this integrated cooperation between medical and surgical clinicians.
