Abdominal pain: general imaging strategies

Acute abdominal pain is the most common condition necessitating surgical admission to a paediatric hospital. The vast majority of cases are due to either appendicitis or acute non-specific abdominal pain; however, there are many other conditions presenting with acute abdominal pain in childhood which can mimic appendicitis. Some of these conditions are rarely encountered in adult practice. Plain abdominal radiographs are still obtained initially on many children presenting with abdominal pain. In the absence of associated symptoms such as vomiting however, ultrasonography (US) is more likely to elucidate the underlying cause of pain than plain-film radiography. While computed tomography (CT) is being used extensively in investigating adults with abdominal pain, its widespread use in children is to be avoided in the interest of radiation protection.