Turck D
Unité de gastroentérologie, hépatologie et nutrition Cliniqué de pédiatrie Hôpital Jeanne de Flandre, Lille.
Rev Prat. 1998 Feb 15;48(4):369-75.
Recurrent abdominal pain has been reported to occur in 10 to 15% of children between the ages of 5 and 15 years, and is considered to be one of the most encountered symptoms in childhood. It is important to avoid a shotgun approach to rule out all potential infectious, inflammatory, structural, and biochemical causes, that leads to an excess of diagnostic tests, as well as to avoid considering every abdominal pain as functional, which leads to a risk of misdiagnosing the rare organic causes of chronic abdominal pain. Careful history and clinical examination, completed if necessary by minimal laboratory investigation, allow either finding clues to the diagnosis of organic causes [represented most often by gastrointestinal diseases (constipation, gastroesophageal reflux) or nephro-urologic diseases] or suggesting that chronic abdominal pain may be of functional origin. Distinguishing between psychosomatic and functional chronic abdominal pain can be sometimes difficult.
据报道,复发性腹痛发生在5至15岁儿童中的比例为10%至15%,被认为是儿童期最常见的症状之一。重要的是要避免采取“霰弹枪式”方法来排除所有潜在的感染性、炎症性、结构性和生化性病因,因为这会导致过多的诊断检查,同时也要避免将每一例腹痛都视为功能性腹痛,否则会有漏诊慢性腹痛罕见器质性病因的风险。仔细询问病史并进行临床检查,必要时辅以最少的实验室检查,这样要么能找到诊断器质性病因(最常见的是胃肠道疾病,如便秘、胃食管反流,或肾-泌尿系统疾病)的线索,要么能提示慢性腹痛可能源于功能性因素。区分心身性慢性腹痛和功能性慢性腹痛有时可能会很困难。