Assessment of Acute Abdominal Pain in Children Presenting to the Emergency Department: A Retrospective Observational Study

Pediatric patients' presentations to the emergency department exhibit a diversity of presentations, and diagnostics may be less evident compared to adult patients. Right lower quadrant pain and leukocytosis may be more indicative of a non-surgical abdomen rather than a surgical abdomen among different diagnoses that require surgical intervention. However, right lower quadrant pain and leukocytosis are still strongly associated with acute appendicitis out of different surgical diagnoses. To combine both findings, our conclusion is that right lower quadrant pain and leukocytosis are more predictive of an acute medical abdomen, but only when appendicitis is less likely to be one of the differential diagnoses. These findings challenge conventional clinical paradigms, suggesting that right lower quadrant pain could be a stronger predictor of medical conditions, which typically do not require surgical intervention.