• Should be a differential diagnosis of abdominal pain in under-5s
  • Typically presents with attacks of severe colicky pain 10 – 20 minutes apart – parents report children drawing up legs to abdomen/kicking legs
  • Onset usually acute but may be insidious
  • Occasionally lethargy can be the only symptom (try that as a differential diagnosis problem)
  • Bilious vomiting indicates obstruction, but note that vomiting is initially clear
  • Bloodstained stools (eventually redcurrant jelly) are a late sign which show loss of blood supply to intestinal mucosa
  • Fever is a late sign
  • Examination between symptoms may find a sausage-shaped mass in the RUQ with emptiness in the RIF.

About Dr Sarah

I'm a GP with a husband and two young children.
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