Paediatric Acute Abdomen: Clinical Patterns and Age-Wise Distribution

Abstract

Background: Acute abdomen in children represents a frequent and diagnostically challenging clinical problem, marked by sudden severe abdominal pain requiring urgent evaluation. The causes in pediatric patients are highly variable and age-dependent, ranging from benign, self-limiting conditions to life-threatening surgical emergencies. Rapid identification and appropriate management are critical to minimize morbidity and mortality. Objectives: This study aimed to analyse the clinical presentation and age-wise distribution of causes of acute abdomen in children presenting to a tertiary care centre, emphasizing the patterns of pain localization and their correlation with underlying etiologies. Methods: A descriptive, observational study was conducted at a tertiary care centre involving 104 consecutive paediatric patients aged 1–14 years presenting with acute abdominal pain. Comprehensive demographic data, clinical symptoms, pain location, laboratory investigations, and imaging findings were recorded and analysed. Patients were divided into three age groups: 1-5 years, 6–10 years, and 11-14 years. Results: Of 104 children enrolled, 59% were males and 41% females, with a progressive increase in cases in older age groups. Periumbilical pain was most frequent in the youngest group (43.3%), while epigastric and right iliac fossa pain became more prominent in older children (27.9% and 25.6% respectively in 11–14 years). Generalized abdominal pain was least common in all groups. The trend in pain localization with increasing age correlated with a shift from nonspecific/infective etiologies (such as gastroenteritis and mesenteric lymphadenitis) in younger children to acid peptic disease and appendicitis in adolescents. Discussion: The findings highlight a clear age-dependent variation in the presentation of paediatric acute abdomen. Recognizing these clinical patterns enhances diagnostic precision, facilitates targeted investigations, and supports early intervention for surgical causes such as appendicitis, while reducing overtreatment of benign or functional conditions.