Abdominal pain among children re-evaluation of a diagnostic algorithm

Table 1 Algorithm for diagnosis of abdominal pain

	Abdominal Pain
Acute abdomen		Non-acute abdomen
(long time pain definite signs)		(short pain no definite sign)
1 Focal inflammation	2 Intestinal obstruction	1 Primary enterospasm
		(allergic, idiopathic)
(1) local tenderness	(1) intestinal pattern	(1) weaning colic
(appendicitis, etc.)	(adhesive obstruction)
(2) tender mass	(2) movable mass	(2) school-boy colic
(torsion ovarian cyst)	(intussusception)
3 generalized peritonitis		2 secondary enterospasm
(full and silent abdomen)		(organic, non-acute)
(1) spreading peritonitis	(2) gangrenous peritonitis	(1) chronic G-I ulcers
(inflamed organ)	(strangulation)	(2) pancreticobiliary colic
(3) perforating peritonitis	(4) primary peritonitis	(3) chronic gastritis
(peptic ulcer, typhoid)	(bacteremia, vaginitis)	(4) cerebrospinal colic
		(5) hemo-vascular disease
		(6) metabolic disease
		(7) auto-immue disorder
		(8) intoxication

*Footnote: (1) "comparative technique" of abdominal palpation, watching different reaction of the child on different part of abdomen. (2) "dynamic comparison" of clinical presentation, is today better or worse than yesterday?