Abdominal pain

Abstract Abdominal pain is a symptom, not a diagnosis. In children, it has many causes, both from within and beyond the peritoneal cavity. A structured approach to its assessment facilitates determination of the underlying cause. In particular, the surgeon is required to identify which children with abdominal pain will benefit from surgery. Consequently, clinical assessment is directed at establishing the presence of: (1) intra-peritoneal inflammation; (2) bowel ischaemia; and (3) obstruction. These may coexist. The key to identifying intra-peritoneal inflammation is demonstration on history taking and clinical examination that movement of adjacent surfaces of the inflamed peritoneum exacerbates the pain.