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Prevalence of pneumonia in children under 12 years of age who undergo abdominal radiography in the emergency department

Published online by Cambridge University Press:  21 May 2015

Valérie Homier ,
Colette Bellavance  and
Marianne Xhignesse
Valérie Homier*
Affiliation:
Faculty of Medicine, University of Sherbrooke, Sherbrooke, Que.
Colette Bellavance
Affiliation:
Faculty of Medicine, University of Sherbrooke, Sherbrooke, Que. Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que.
Marianne Xhignesse
Affiliation:
Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que.
*
Royal Victoria Hospital, 687 Pine Ave, West, Room A4.62, Montréal QC H3A 1A1; [email protected]

Abstract

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Objective:

Pneumonia is a well-known cause of acute abdominal pain in children. However, the utility of chest radiography in this setting is controversial. We sought to determine the prevalence of pneumonia in children under 12 years of age who had abdominal pain and underwent abdominal radiography when visiting an emergency department (ED). We also aimed to describe the signs and symptoms of children diagnosed with pneumonia in this context.

Methods:

We conducted a retrospective analysis of electronic data from ED visits to a tertiary care centre by children 12 years of age and under who were seen between June 1, 2001, and June 30, 2003, and who underwent both an abdominal and a chest radiograph during the same visit, or an abdominal x-ray at a first visit as well as a chest x-ray in the 10 days following the initial visit.

Results:

Of 1584 visits studied, 30 cases of pneumonia were identified, for a prevalence of 1.89% (95% confidence interval 1.22%–1.56%). If chest radiography had been limited to children who presented with fever, cough and symptoms of an upper respiratory tract infection (URTI), the diagnosis of pneumonia would have been missed in only 2/1584 visits (0.13%).

Conclusion:

Children aged 12 years and under presenting to the ED with acute abdominal pain and in whom an abdominal radiograph is requested need only undergo a chest radiograph in the presence of cough, fever or other symptoms of a URTI.

Keywords

abdominal painchildrenemergencypneumoniachest x-ray
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 9 , Issue 5 , September 2007 , pp. 347 - 351
Copyright
Copyright © Canadian Association of Emergency Physicians 2007

References

1. Purcell, TB. Nonsurgical and extraperitoneal causes of abdominal pain. Emerg Med Clin North Am 1989;7:721–40.CrossRefGoogle ScholarPubMed
2. Kirschner, BS. The gastrointestinal tract. In: Nelson essentials of pediatrics. 4th ed. Behrman, RE, Kliegman, RM, editors. Philadelphia (PA): W.B. Saunders Company; 2002. p 469–71.Google Scholar
3. Black, DD. The respiratory system. In: Nelson essentials of pediatrics. 4th ed. Behrman, RE, Kliegman, RM, editors. Philadelphia (PA): W.B. Saunders Company, 2002. p 541–4.Google Scholar
4. Prober, CG. Pneumonia. In: Nelson textbook of pediatrics. 16th ed. Behrman, RE, Kliegman, RM, Jenson, HB, editors. Philadelphia (PA): W.B. Saunders Company, 2000. p 761–5.Google Scholar
5. Ulshen, M. Major signs and symptoms of digestive tract disorders. In: Nelson textbook of pediatrics. 16th ed. Behrman, RE, Kliegman, RM, Jenson, HB, editors. Philadelphia (PA): W.B. Saunders Company; 2000. p 1102–6.Google Scholar
6. Lillis, KA. Gastrointestinal disorders. In: Barkin, RM, editor. Pediatric emergency medicine: concepts and clinical practice. 2nd ed. St. Louis (MO): Mosby-Year Book Inc.; 1997. p 797–804.Google Scholar
7. Letourneau, MA, Schuh, S, Gausche, M. Respiratory disorders. In: Barkin, RM, editor. Pediatric emergency medicine: concepts and clinical practice. 2nd ed. St. Louis (MO): Mosby-Year Book, Inc; 1997. p 1102–8.Google Scholar
8. Ruddy, RM. Pain-abdomen. In: Textbook of pediatric emergency medicine. 4th ed. Feisher, GR, Ludwig, S, editors. Philadelphia (PA): Lippincott Williams & Wilkins; 2000. p 421–8.Google Scholar
9. Freimanis, AK, Nelson, SW. The chest roentgenogram in the diagnosis of acute abdominal disease. Radiol Clin North Am 1964;2:3–20.CrossRefGoogle ScholarPubMed
10. Jona, JZ, Belin, RP. Basilar pneumonia simulating acute appendicitis in children. Arch Surg 1976;111:552–3.CrossRefGoogle ScholarPubMed
11. Jona, JZ, Selke, AC, Belin, RP. Radiologic aids in the diagnosis of appendicitis in children. South Med J 1975;68:1373–6.CrossRefGoogle Scholar
12. Swischuk, LE. Emergency imaging of the acutely ill or injured child. 3rd ed. Baltimore (MD): Williams & Wilkins; 1994. p 222–3.Google Scholar
13. Hayes, R. Abdominal pain: general imaging strategies. Eur Radiol 2004;14:L123–37.Google ScholarPubMed
14. Spencer, PAS. Pneumonia, diagnosed on the abdominal radiograph, as a cause for acute abdomen in children. Br J Radiol 1990;63:306–8.CrossRefGoogle ScholarPubMed
15. Ravichandran, D, Burge, DM. Pneumonia presenting with acute abdominal pain in children. Br J Surg 1996;83:1707–8.CrossRefGoogle ScholarPubMed
16. Vendargon, S, Wong, PS, Tan, KK. Pneumonia presenting as acute abdomen in children: a report of three cases. Med J Malaysia 2000;55:520–3.Google ScholarPubMed
17. Cope’s early diagnosis of the acute abdomen. 20th ed., revised by William, Silen. New York (NY): Oxford University Press; 2000. p 58, 273–5.Google Scholar
18. Bates, B. Guide de l’examen clinique, 4e édition. Reuil-Malmaison: Arnette, 2001. p. 739.Google Scholar
19. Sims, DG, Alexander, FW. Acute abdominal pain in childhood. BMJ 1976;2:880–1.CrossRefGoogle ScholarPubMed
20. Jones, PF. Active observation in management of acute abdominal pain in childhood. BMJ 1976;2:551–3.CrossRefGoogle ScholarPubMed