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What Causes Abdominal Pain In A Child?
Question: Hi my daughter 5 years old. She have abdominal pain for a few seconds at a time but several times a day. ultrasound show enlarge lymph nodes. blood test show low blood counts 2weeks ago and today i just test again and turns out the white blood count is a bit lower than before but today results comes out with lymphosite higher than normal then neutrophil lower then normal. she have been to 2 gastroenterologist and 3 paeditrician and the pain still there. its been 1 month already and i am very worried. She test her urine and stool as well all turns out good. no bacteria found and also test for helicobacter and also turns out negative. so far the probiotic called LACTEOL FORT seems to make her feel better although the pain is still there.
Brief Answer:
Constipation and worm infestation to be ruled out
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Dear Ms XXXXXXX
Being a parent myself I understand your concern and apprehension.
Lets analyse the complaints , the only positive history is pain in abdomen.
In the absence of other associated symptoms like fever, loss of appetite/weight, urinary complaints, bowel disturbance its unlikely to be something serious.
I assume general physical examination done by the Physicians has not revealed any other positive finding including enlarged lymph nodes elsewhere.
Lets analyse the Investigation:
1.Previous leucocyte count is definitely low(3800cells/mm cube). Present value is 4700 cells/mm cube . In children its quite common to see reversal of lymphocyte and neutrophil . Lymphocytes may sometimes be high.
2. Ultrasound: 13.8 * 6 mm Mesenteric lymph nodes.
Children around the age of 4 to 7 years have overgrowth of lymphatic tissue like tonsil, adenoids and mesenteric lymph nodes.
So its very usual finding to see such nodes. They are not likely to cause symptoms. But will require to be followed up with repeat Ultrasound.
had she been my patient I would have managed her in the following way
1. Course of antibiotic: Cefixime 5mg/kilogramme per dose twice a day for 7 days. It is required to cause resolution of size of mesenteric nodes
2. Peripheral blood smear and blood picture
3. Antispasmodics: Hyoscine butyl bromide syrup may be helpful
4. Follow up Ultrasound to note the regression in size of mesenteric nodes after antibiotic: usually done after 2 weeks
5. Antihelminthic: Depending on your Geogrophical location Albendazole 400 mg single dose is definitely indicated
Ultrasound abdomen done especially at time of pain will definitely be more helpful. Possibility of worm infestation is also to be considered. I hope there is no constipation and she is passing soft stools regularly.
Constipation is one of the commonest cause for colicky pain in children.
If the symptoms do not respond to treatment, she will require further evaluation by Barium meal and follow through. If still inconclusive diagnostic Laparoscopy can be planned.
Please keep me informed about the progress of baby.
Wishing you and your family a happy and healthy life
Take Care
Best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Pediatric Surgeon
Constipation and worm infestation to be ruled out
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Dear Ms XXXXXXX
Being a parent myself I understand your concern and apprehension.
Lets analyse the complaints , the only positive history is pain in abdomen.
In the absence of other associated symptoms like fever, loss of appetite/weight, urinary complaints, bowel disturbance its unlikely to be something serious.
I assume general physical examination done by the Physicians has not revealed any other positive finding including enlarged lymph nodes elsewhere.
Lets analyse the Investigation:
1.Previous leucocyte count is definitely low(3800cells/mm cube). Present value is 4700 cells/mm cube . In children its quite common to see reversal of lymphocyte and neutrophil . Lymphocytes may sometimes be high.
2. Ultrasound: 13.8 * 6 mm Mesenteric lymph nodes.
Children around the age of 4 to 7 years have overgrowth of lymphatic tissue like tonsil, adenoids and mesenteric lymph nodes.
So its very usual finding to see such nodes. They are not likely to cause symptoms. But will require to be followed up with repeat Ultrasound.
had she been my patient I would have managed her in the following way
1. Course of antibiotic: Cefixime 5mg/kilogramme per dose twice a day for 7 days. It is required to cause resolution of size of mesenteric nodes
2. Peripheral blood smear and blood picture
3. Antispasmodics: Hyoscine butyl bromide syrup may be helpful
4. Follow up Ultrasound to note the regression in size of mesenteric nodes after antibiotic: usually done after 2 weeks
5. Antihelminthic: Depending on your Geogrophical location Albendazole 400 mg single dose is definitely indicated
Ultrasound abdomen done especially at time of pain will definitely be more helpful. Possibility of worm infestation is also to be considered. I hope there is no constipation and she is passing soft stools regularly.
Constipation is one of the commonest cause for colicky pain in children.
If the symptoms do not respond to treatment, she will require further evaluation by Barium meal and follow through. If still inconclusive diagnostic Laparoscopy can be planned.
Please keep me informed about the progress of baby.
Wishing you and your family a happy and healthy life
Take Care
Best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Pediatric Surgeon
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
hi, when you said other symptom. i realize that she said she have this a bit tingling and sometimes pain she said in her vagina area a few times this week, however the urine cultur and urinalisis turns out nothing.
Then the present value of low white blood cell is 3800 with high lymphocytes and low neutrophil. The result 4700 is before that and with normal lymphocyte and neutrophil. so it means the white blood getting lower.
i also havent told u that she always have abdominal pain in this specific area in her belly button around just 1 Centimeter above it. thanks
she also lose a bit of weight but i just assume maybe because she is in strict diet of soft food. thank you by the way to reply my question within minutes. really relieve knowing someone there ready to help. thank you again and god bless.
Then the present value of low white blood cell is 3800 with high lymphocytes and low neutrophil. The result 4700 is before that and with normal lymphocyte and neutrophil. so it means the white blood getting lower.
i also havent told u that she always have abdominal pain in this specific area in her belly button around just 1 Centimeter above it. thanks
she also lose a bit of weight but i just assume maybe because she is in strict diet of soft food. thank you by the way to reply my question within minutes. really relieve knowing someone there ready to help. thank you again and god bless.
Brief Answer:
Get Peripheral blood smear
Detailed Answer:
Hi
Greetings.
Thank you for the good wishes.
If there is no vaginal discharge and no redness in area around the vagina then its unlikely to be significant. I would advise the following for pain in vagina
1. Hot Seitz bath: To a tub containing lukewarm water add handful of common table salt. Make baby sit in it for 15 to 20 minutes. It will reduce the pain.
For the decrease in leucocyte count, i would suggest you to get peripheral smear examination of blood. Its a routine test, in order to avoid missing anything significant.
Pain around belly that is umbilicus is likely to be small intestine colic. Worm infestation could be one of the cause. I would suggest you to carry out the previous advise, in case you need any further assistance will always be there.
Do keep me posted about the progress.
Wishing you and your family a happy and healthy life.
Take Care
Regards
Deepak
Get Peripheral blood smear
Detailed Answer:
Hi
Greetings.
Thank you for the good wishes.
If there is no vaginal discharge and no redness in area around the vagina then its unlikely to be significant. I would advise the following for pain in vagina
1. Hot Seitz bath: To a tub containing lukewarm water add handful of common table salt. Make baby sit in it for 15 to 20 minutes. It will reduce the pain.
For the decrease in leucocyte count, i would suggest you to get peripheral smear examination of blood. Its a routine test, in order to avoid missing anything significant.
Pain around belly that is umbilicus is likely to be small intestine colic. Worm infestation could be one of the cause. I would suggest you to carry out the previous advise, in case you need any further assistance will always be there.
Do keep me posted about the progress.
Wishing you and your family a happy and healthy life.
Take Care
Regards
Deepak
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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