Final Diagnoses of Acute Abdominal Pain in Children Presenting to a Pediatric Emergency Department in Tehran, Iran: A Single-Center Cross-Sectional Study

Abstract

Background: Acute abdominal pain is among the most common reasons for visits to a pediatric emergency department. A major diagnostic challenge is distinguishing abdominal pain that requires surgical intervention from conditions that can be managed medically. Objectives: This study aimed to evaluate the final diagnoses of children presenting with acute abdominal pain at the emergency department of Mofid Children’s Hospital in Tehran, Iran. Methods: This retrospective cross-sectional study included 200 children with acute abdominal pain who presented to Mofid Children’s Hospital, Tehran, Iran, between January and March 2021. Data were extracted from medical records under a waiver of informed consent approved by the institutional ethics committee. Patients were categorized into medical and surgical treatment groups. Demographic, clinical, and diagnostic variables were compared using SPSS version 27, and P < 0.05 was considered statistically significant. Results: Of 200 children, 40 (20.0%) underwent surgery, whereas 160 (80.0%) received medical treatment only. The overall mean age was 6.99 ± 2.64 years, and 41.0% of the participants were male; no significant differences in age or sex were observed between the groups. The most common final diagnosis was gastroenteritis (50.5%), followed by appendicitis (13.5%) and constipation (8.0%). Among surgically managed cases, appendicitis accounted for 67.5%, whereas gastroenteritis was the most common diagnosis in the medical group (63.1%). Conclusions: Most cases of pediatric acute abdominal pain in this study were managed medically; however, a substantial proportion required timely surgical evaluation. Accurate history taking, a thorough physical examination, and appropriate diagnostic investigations remain essential for determining the optimal management pathway.