ACUTE ABDOMEN IN PEDIATRIC PRACTICE

Аннотация

The patient's fate often depends on the doctor's ability to correctly interpret abdominal pain. The article provides a detailed analysis of thepathogenesis of abdominal pain andsystematizes the main causes of "acute abdomen" in children. Particular attention is paid to the differential diagnosis of acute surgical diseases of the abdominal organs in children. The structure of the "acute abdomen" syndrome in children over 1year old intheemergency surgery clinicis analyzed. Kеywоrds: children, acute abdomen, pain, abdominal pain, causes, diagnostics, differential diagnosis, acute appendicitis. INTRОDUСTIОN Acute abdomen is one of the most common and multifaceted syndromes that cannot be precisely defined. The constant reference to the topic of "acute abdomen" can have only one explanation: there is no problem that unites a surgeon and a pediatrician more than abdominal pain. When faced with complaints from patients and theirparents about abdominal pain, each of us,first ofall, decides: to a surgeon or a pediatrician? Traditionally, the term "acute abdomen" is associated with the need for emergency surgical intervention. The doctor who is the first to examine the patient must make a fairly quick decision. The task of primary diagnosis is to recognize a dangerous situation and the need for urgent surgical treatment. And very often the burden of responsibility falls on the shoulders of the pediatrician: his decision determines how quickly a patient with a surgical problem gets to a specialist. From this position, the situation of “acute abdomen” is always surgical, accordingly, at the slightest suspicion of “acute abdomen”, the pediatrician should refer the patient for consultation with asurgeon. MАTЕRIАLSАNDMЕTHОDS By "acute abdomen" in the broad sense of the word we mean a disease characterized by sudden severe abdominal pain requiring surgical treatment. However, not all patients referred to the emergency room are hospitalized, and no more than 1/4 of patients hospitalized in the abdominal surgery department for acute abdominal pain require surgical treatment. So what is hidden under the term "acute abdomen"? The causes of abdominal pain are numerous. Most manuals for doctors provide a long list of diseases that occur with abdominal pain syndrome. Moreover, in childhood, given the dysfunction of regulatory systems, the tendency of children to generalized reactions and the inability to clearly localize pain, this list is almost endless. But for a practicing physician, knowledge of all possible exotic causes of acute abdomen is hardly extremely necessary and useful. It is very important to differentiate between surgical diseases of the abdominal organs and somatic pathology, and also to remember, in cases where it is not obvious, about abdominal trauma. In general, numerous diseases accompanied by abdominal pain can be reduced to several etiological factors [1]. RЕSULTSАNDDISСUSSIОN The main clinical symptoms of acute abdomen are: pain, vomiting, intestinal dysfunction, and urinary dysfunction. Pain is the main distinguishing symptom of "acute abdomen". It is observed in almost all cases and may be the only symptom, especially at an early stage of the disease. Pain is a subjective human sensation, so its assessment can be difficult and depends on the doctor's experience. The ability to adequately interpret pain is one of the main requirements for a doctor, especially a pediatrician. Young children are not able to characterize pain, since they are not able to assess their well-being and do not localize pain well enough [2]. Determining the nature of pain in 164 INTERNATIONAL MULTIDISCIPLINARY JOURNAL FOR RESEARCH & DEVELOPMENT SJIF2019:5.2222020:5.5522021:5.6372022:5.4792023:6.5632024:7,805 eISSN:2394-6334 https://www.ijmrd.in/index.php/imjrd Volume12,issue03(2025) newborns is especially difficult. It is important to remember that babies convey a state of discomfort and pain through their behavior, which in young children is manifested by anxiety. Anxiety can be manifested by intense crying, "twisting" and pulling the legs up to the stomach, and refusal to eat. If the child can speak, it is very important not to limit yourself to the parents’ story: children over 3 years old can quiteclearly tellwhat and where it hurts. There are several types of abdominal pain: visceral, parietal (somatic), reflex, psychogenic. The most significant for acute abdomen are visceral and somatic pain, the differences between which are important to know for successful diagnosis of pain syndrome. Pain impulses originating in the abdominal cavity are transmitted both through autonomic nerve fibers and through the anterior and lateral spinothalamic tracts. Pain impulses that are conducted through the spinothalamic tracts are characterized by clear localization. These pains (parietal, somatic) occur when the nerve endings of the parietal peritoneum, the root of the mesentery, the retroperitoneal space, layers of the abdominal wall are irr