Children frequently have acute abdominal pain. The physician must identify which child has a potentially catastrophic condition (<2%). Because the number of patients requiring immediate action is low, the physician can be lulled into a sense of safety. Infrequently, acute abdominal pain can be catastrophic, so the physician needs to be cognizant of conditions requiring action. Knowledge and judgment are key.

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Acute abdominal pain is a frequent and challenging problem facing pediatricians. The cause of acute abdominal pain can range from John Apley’s “little bellyacher” (1) to an emergency requiring immediate action. Assessing acute abdominal pain is a situation that requires excellent clinical acumen, an area where pediatricians should “prove their worth” by outperforming other primary caregivers. Making the correct diagnosis may earn the pediatrician accolades for saving a life (as in the case of intussusception or midgut volvulus)...

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