Douleurs abdominales aiguës non traumatiques

Acute abdominal pain is one of the most common complaints in children (3-5% of emergency visits), and it poses a diagnostic challenge owing to the variety of underlying causes. Although most of them are due to benign diseases, the risk is to ignore a surgical or medical emergency, with consequences of delay in treatment and a poorer prognosis. Causes are numerous and vary according to age, including surgical emergencies (appendicitis, intussusception), medical abdominal diseases (gastroenteritis), and extra-abdominal causes (pneumonia, pharyngitis), general diseases (diabetes, drepanocytosis) and functional pains. Anamnesis and clinical exam are essential for diagnosis. Complementary exams, and firstly abdominal ultrasonography, are useful to confirm diagnosis with sufficient pre exam probability based on prevalence and clinical data. The diagnosis of appendicitis can be difficult in atypical presentations. A repeated surgical exam 6 to 12 heures later is the most useful. Prescription of antalgics is needed and can facilitate the diagnosis by making the clinical exam easier in a cooperating child.