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CHAPTER 116 ■ ABDOMINAL EMERGENCIES
SUSAN C. LIPSETT, RICHARD G. BACHUR

GOALS OF EMERGENCY CARE
Pediatric abdominal complaints are common, and ED physicians are challenged
to distinguish common, innocent gastrointestinal complaints from surgical
emergencies. Logical diagnostic strategies and prompt recognition of surgical
emergencies should be the goal of the evaluation. For abdominal surgical
emergencies, the clinical evaluation should focus on timely recognition of a
surgical condition and early involvement of a surgeon. Ideal care would limit
complications such as peritonitis and ischemic bowel.
KEY POINTS
Bilious emesis in a young infant is a surgical emergency
Young children with appendicitis often have atypical presentations
Intussusception can present with profound altered mental status
Bloody stool or blood per rectum may represent ischemic bowel
RELATED CHAPTERS
Signs and Symptoms
Abdominal Distension: Chapter 12
Constipation: Chapter 18
Gastrointestinal Bleeding: Chapter 33
Pain: Abdomen: Chapter 53
Medical, Surgical, Trauma
Gastrointestinal Emergencies: Chapter 91
Gynecology Emergencies: Chapter 92
Abdominal Trauma: Chapter 103

ACUTE NONPERFORATED APPENDICITIS
CLINICAL PEARLS AND PITFALLS