Chronic abdominal pain in children: help in spotting the organic diagnosis.

To cite: Wright NJ, Hammond PJ, Curry JI. Arch Dis Child Educ Pract Ed 2013;98:32–39. CASE 1 Aisha, a 9-year-old Asian girl, was referred to the paediatric outpatient clinic by her general practitioner (GP) with a 4 month history of episodic central abdominal pain. Each episode would last a few hours, affecting her about three times per week, usually during the day, but also occasionally at night. This was associated with infrequent, non-bilious vomits but did not appear to be related to diet. She was missing some days of school because of her symptoms. She said she liked school, did not like missing days away from her friends and denied any bullying. Between episodes she was a well and active girl. She had no history of diarrhoea or constipation, was growing well, had no urinary symptoms and had not reached menarche. She was born at term via normal vaginal delivery and had no neonatal problems. She had no significant past medical history, was not on any medications and was fully immunised. There was no history of foreign travel and no family history of bowel problems. General physical examination was unremarkable. Abdominal examination revealed no distension, organomegaly, palpable masses or herniae and no tenderness on the day of her clinic visit. She was on the 75th centile for weight, which was consistent with previously documented weights.