CHAPTER 116 ■ ABDOMINAL EMERGENCIES SUSAN C LIPSETT, RICHARD G BACHUR GOALS OF EMERGENCY CARE Pediatric abdominal complaints are common, and ED physicians are challenged to distinguish common, innocent gastrointestinal complaints from surgical emergencies Logical diagnostic strategies and prompt recognition of surgical emergencies should be the goal of the evaluation For abdominal surgical emergencies, the clinical evaluation should focus on timely recognition of a surgical condition and early involvement of a surgeon Ideal care would limit complications such as peritonitis and ischemic bowel KEY POINTS Bilious emesis in a young infant is a surgical emergency Young children with appendicitis often have atypical presentations Intussusception can present with profound altered mental status Bloody stool or blood per rectum may represent ischemic bowel RELATED CHAPTERS Signs and Symptoms Abdominal Distension: Chapter 12 Constipation: Chapter 18 Gastrointestinal Bleeding: Chapter 33 Pain: Abdomen: Chapter 53 Medical, Surgical, Trauma Gastrointestinal Emergencies: Chapter 91 Gynecology Emergencies: Chapter 92 Abdominal Trauma: Chapter 103 ACUTE NONPERFORATED APPENDICITIS CLINICAL PEARLS AND PITFALLS