بررسی علل دل درد مزمن در کودکان مراجعه کننده به مرکز طبی کودکان تهران

Objective: Recurrent abdominal pain (RAP) affects a significant number of children each year. It can be defined as experience of at least three episodes of pain، severe enough to affect activities، over a period of three months. The purpose of this study was to determine the organic and non-organic causes of RAP. Also، evaluate different variables of RAP such as age، sex، location and duration of pain، accompanying symptoms and stressful life events in two groups.
Material & Methods: During one year period from October 2003 to September 2004، 70 children (aged 4-12 years)، were investigated in a referral Children''s Center in Tehran. All patients underwent a thorough interview and complete physical examination and an initial sample of blood، urine، and stool evaluation. If any evidence of alarm symptoms (such as vomiting and night pain) were observed، additional studies were performed including abdominal ultrasonography، radiography، and/ or upper gastrointestinal Endoscopy.
Findings: An organic cause was found in 21 (30%) patients and non-organic cause was identified in 49 (70%) cases. Main observations in non-organic groups were: more periumblical pain location، positive history for stressful life events in child and their family. Also، gastrointestinal problems were the most common organic causes in 60% of children. Other organic causes were urinary tract infections 10%، kidney stone 10%، cholelitiasis (5%)، Giardiasis (15%)، and abdominal migraine (5%). Endoscopy seems to be a safe and reliable method in diagnosis of a number of organic lesions otherwise not detected by ordinary investigations. Our data suggest that among the children with RAP، non-organic causes are more commons (70%) than organic causes (30%).
Conclusion: This study showed that in spite of accessing to better instruments in medical sciences in recent decades، the percentage of nonorganic RAP in children is still high.