356 Po989 Recurrent Abdominal Pain In Children With Previous Appendectomy

Marija Tosic Mijajlovic1, Ivana Bivolarevi´c e Jelena Mitrovic2
1Health care centre Dr SimoMilosevic, Belgrade; 2Primary health care Centre"Dr Simo Milosevic"
Introduction: Recurrent abdominal pain is defined as minimum of three episodes of abdominal pain in three months period of time, which are often severe and in between there are periods of normal child activity. Organic aetiology is rare. When no specific cause is found, the pain is defined as functional, because of emotional stress.
Case report: Girl at the age of 12, has recurrent abdominal pain starting in September 2012. The pain disturbs normal activities more often. Paediatrician thinks it is dysmenorrhoea, but there is no pattern in frequency and rhythm. Personal case-history: Gangrenous appendicitis operation in august 2011. Physical examination: Abdomen is soft with diffuse pain to deep palpation, especially in the right hypochondria. Scarf from appendectomy. Laboratory analyses where in order, stool examination too, H .pylori test was negative, ultrasound was normal. Because of the severe pain the girl was examined by a surgeon and gynaecologist in April 2013 in University children clinic, and sent to gastroenterologist. The gastroenterologist examined her and sent her to psychologist. The pain was considered as functional. In the mean time the girl is having recurrent abdominal pain and often absent from school. 18.04.2013. A new surgeon examined her in UCC and indicated exploratory laparoscopy. The operation showed ileum adhesions after almost a year of examination, and two years after appendectomy. The surgeon did laparoscopic adhesiolysis and resection. Since the operation the child did not experience any abdominal pain.
Conclusion: When ever there is recurrent abdominal pain in a child with previous abdominal operation we should look for organic cause of the pain.
recurrent abdominal pain; adhesion; exploratory laparoscopy