Carolinas Core Concepts Core Concepts in EM; a repository for Carolinas lecture summaries.


Pediatric Abdominal Pain

Michael Preis, DO

  • FAST scan in trauma for children is controversial.
    • Sensitivity of 66-83%
  • In appendicitis, the positive likelihood ratio of WBC and CRP combined is 7.75 but only between 4-5 individually.
  • Time is testicle – Salvage rate related to time.
    • 4 hours – 96%
    • 12 hours – 20%
    • 24 hours – 10%
  • Intussusception
    • Imaging modality depends on clinical suspicion
      • High likelihood: Air contrast or barium enema
      • Moderate or low likelihood: ultrasound
        • Have to be aware that ultrasound may miss diagnosis especially if the child doesn’t have pain during exam
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