Pediatric abdominal migraine as a recurrent emergency department presentation: a case report

Pediatric functional abdominal disorders are some of the most commonly encountered disorders in childhood, and a recurrent presentation in the emergency department. Distinguishing functional disorders from organic causes is crucial to safe patient care and to identify optimal treatment strategies. We present a case of a 9-year-old boy with recurrent presentations of diffuse abdominal pain associated with nausea, recurrent vomiting and headache. He had no red flag symptoms, and his mother had a history of migraine headaches. Emergency department investigations demonstrated normal bloodwork, with ultrasound demonstrating only trace small volume deep pelvic ascites of unknown etiology. He was subsequently diagnosed with pediatric abdominal migraine, and counselled on the cornerstones of nonpharmacologic management. This case highlights the importance of assessing for red flags of abdominal pain and using strict diagnostic criteria when considering functional abdominal disorders in childhood.