I can't get up and go to school. "

Every child will encounter stomachache in the process of growth and development.

Whenever this happens, we always send out a kind of soul torture:

"The child has a stomachache. Where does it hurt? "

"I always have a stomachache. Will there be other diseases? "

……

In Dr. Zhang's view, the abdomen is a fairly large area, and stomachaches in different positions and different natures may indicate diametrically opposite diseases.

It's also a stomachache. Some children may be full and can be relieved without seeing a doctor.

But some may be serious diseases or even life-threatening. ...

Under what circumstances do you need to take your child to the hospital?

Go to the hospital to hang up internal medicine or surgery?

Can we observe at home?

In response to parents' questions, in this issue, we invited Dr. Zhang Dan, deputy director of basic surgery of Beijing Children's Hospital affiliated to Capital Medical University, to see what the doctor said ...

1

The child has a stomachache. Where does it hurt?

In the video, Dr. Zhang mentioned that in clinical practice, parents who bring their babies to the hospital with stomachache are often encountered.

I often meet parents who always give their children medicine to relieve pain, no matter what the cause is.

But these practices are not correct in the eyes of professionals.

The child has a stomachache. What should parents do?

In this regard, Dr. Zhang suggested that the child have a stomachache. We must first distinguish what kind of abdominal pain the child has, and then make a judgment.

Physiological abdominal pain

The most common is what we often call intestinal spasm, which is more common in preschool children.

Its typical manifestation is abdominal pain without obvious inducement, with mild symptoms and no symptoms such as vomiting, diarrhea and fever. The pain is mostly located around the navel, and there is no obvious tenderness when pressing the abdomen, which will be relieved within a few minutes.

There is also a common physiological abdominal pain caused by constipation. This kind of abdominal pain often has severe symptoms, but the symptoms can disappear after defecation.

For physiological abdominal pain, most children will be relieved within a few minutes, and they can play, move and eat normally without being affected.

Internal abdominal pain

It is a kind of abdominal pain caused by non-organic diseases and the most common reason for seeing a doctor.

Common diseases include acute gastroenteritis, mesenteric lymphadenitis, gastrointestinal cold and dyspepsia. This kind of abdominal pain is characterized by mild degree, but it can last or recur.

Although the symptoms of abdominal pain in children persist, they will not worsen. Compared with abdominal pain, other symptoms are usually more obvious, such as vomiting, diarrhea and fever.

Surgical abdominal pain

It is caused by the most serious disease of abdominal pain in children, which can have a clear pain site and can cause local tenderness in severe cases.

Common diseases include acute appendicitis, intussusception, biliary tract perforation, digestive tract perforation, intestinal obstruction, ovarian torsion, biliary tract malformation and digestive tract malformation.

The symptoms of abdominal pain caused by this kind of disease are more serious, and children may have obvious symptoms of acute abdomen, such as passive posture and abdominal refusal, and vomiting caused by intestinal obstruction will have yellow-green bile spit out.

In a word, abdominal pain caused by surgical diseases is severe, and it persists before the cause is relieved, or it can break out in a short time and get worse gradually.

Therefore, only by clarifying the cause of the child's abdominal pain can the child's condition be effectively solved in the first time.

Is there a more specific method?

We can make a preliminary judgment according to the specific location of the child's pain.

2

Children have stomachache, how should parents judge correctly?

If it is enlightening and helpful, please forward it.

The child has a stomachache, but he can't say exactly where it hurts, which worries some parents.

In view of this situation, Dr. Zhang suggested that you can judge by four points.

The quartering method takes the navel as the center and draws a cross vertically and horizontally, which is divided into four areas: left upper abdomen, left lower abdomen, right upper abdomen and right lower abdomen.

There is also a related area in the abdomen, namely the groin and perineum.

Only by defining these areas can we make a more accurate judgment.

For example, anatomically speaking:

The left upper abdomen is usually the stomach;

The midabdomen is the duodenum;

The right upper abdomen is usually the liver and gallbladder;

The right lower abdomen is the terminal ileum and appendix.

According to the pain site, the abdominal pain caused by upper digestive tract such as gastritis, cholecystitis and duodenal inflammation is located in the middle and upper abdomen.

Because cholecystitis in children is extremely rare, the possibility of acute gastroenteritis should be considered when upper abdominal pain is accompanied by vomiting.

The right lower abdomen is the appendix, but sometimes another disease, acute mesenteric lymphadenitis, will appear as pain in the right lower abdomen.

Constipation is a typical left abdomen, and parents can even feel the lump from the outside, but it will be fine if it is discharged.

There is also lower abdominal pain, which is most common in colon inflammation and mesenteric lymphadenitis, and may have diarrhea symptoms.

There is also a unique ovarian emergency for girls, but the ovaries are usually left and right, so they are characterized by severe pain in the lower abdomen and cannot move.

In addition, it should be noted that some abdominal lesions can also be manifested as abdominal pain symptoms, such as sudden inguinal hernia, testicular torsion and so on.

Therefore, the scope of abdominal physical examination of children should include bilateral inguinal region and bilateral scrotum.

three

The child has a stomachache, which subject should he hang?

In the video, Dr. Zhang mentioned that many parents will have questions. Which subject should children choose for stomachache?

Dr. Zhang suggested that if the child has physiological abdominal pain and does not affect his life, this situation can be observed at home first.

But if it's a stomachache that recurs within two hours and gets worse every time, you should come to the hospital in time.

There is also a typical abdominal pain, accompanied by fever, vomiting, diarrhea and other symptoms. This situation should also be dealt with in time.

If the above situation occurs, you can hang up the internal medicine department first, and the doctor will determine the corresponding diagnosis and treatment standards according to the severity of the child. Most children will choose to have an abdominal ultrasound examination. First, we will rule out more serious surgical diseases, such as appendicitis, or intussusception and intestinal obstruction in children.

For typical children with enteritis, it can be manifested as vomiting, diarrhea and fever, and the child has a recent history of unclean diet. It can be directly linked to the Department of Gastroenterology to remove intestinal infection diseases caused by external factors.

In addition, for patients with long-term epigastric pain, we need to rule out gastric ulcer and duodenal ulcer, but the diagnosis and treatment of children and adults are different.

Children may be accompanied by congenital diseases such as intestinal malformation and biliary malformation. Although the incidence rate is not high, it is still necessary to rule out this serious structural disease through surgical examination.

If no abnormalities are found in the respiratory digestive tract and hepatobiliary system during routine examination, then we will take our children to internal medicine, such as gastroenterology and traditional Chinese medicine, for detailed examination and then specialist treatment.

Source Capital Education WeChat official account

Process editor Li