Acute Abdominal Pain

Age Emergent Nonemergent
0–3 mo old Necrotizing_Enterocolitis Colic
Malrotation/Volvulus Acute gastroenteritis
Pyloric Stenosis Constipation
Testicular torsion  
Incarcerated hernia  
Toxic megacolon  
3 mo–3 y old Intussusception Acute gastroenteritis
Testicular torsion Constipation
Trauma Urinary tract infections
Malrotation/Volvulus HSP
Toxic megacolon  
Vaso-occlusive crisis  
3 y old–adolescence Appendicitis Constipation
Diabetic ketoacidosis Acute gastroenteritis
Vaso-occlusive crisis Nonspecific viral syndromes
Toxic ingestion Streptococcus pharyngitis
Testicular torsion Urinary tract infections
Ovarian torsion Pneumonia
Ectopic pregnancy Pancreatitis
Trauma Cholecystitis
Toxic megacolon Renal stones
Tumor HSP
  Inflammatory bowel disease
  Gastric ulcer disease/gastritis
  Ovarian cyst


Common Parenteral Analgesics for Abdominal Pain in Children
Drug Dose
Morphine sulfate 0.05–0.1 mg/kg/dose IV every 4 h in neonates.
0.1 mg/kg/dose IV every 2–4 h in infants and children.
Hydromorphone 0.015 mg/kg/dose IV every 3–6 h if 6 mo old and <50 kg.
If weighing >50 kg, use adult dosing.
Fentanyl 1–2 mcg/kg/dose IV every 30–60 min.
Ketorolac 0.5 mg/kg/dose IV every 6 h (maximum of 30 milligrams per dose) if 6 mo old.